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PROCEEDINGS 

Fortieth Annual Meeting 

AMERICAN 

MEDICAL EDITORS 

ASSOCIATION 



Atlantic City, N. J. 

JUNE FIFTH AND SEVENTH 
Nineteen Hundred and Nine 



PUILISHED BV THE SECRETARV 

Ninety-Two William Street, New York 



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OfRceVB, 1909^1910 
ptestlKnt 

W. A. YOUNG, M.D., 



CANADIAN JOURNAL OF MBDICINB AND SDRCBKV 

f mt Vlcc-|>re0l»ent 
W. A. JONES, M.D., 



JOCRKAL OF THE 



Scconti Vfce-presfOent 

M. M. S. JOHNSTONE. M.D., 



Sectetirfi inD Uteaeatct 

J. MacDONALD, Jr., M.D. 



AMERICAN JOURNAL OF 

Siecntive Committee 

J. J. TAYLOR, M.D., Chairman. 



THB MHDICAl. CODNCII. 

W. C. ABBOTT, M.D., 



AHSUCAN JOURNAL 

C. L. STEVENS, M.D., 

PENNSYLVANIA MEDICAL JOURNAL 

pnblfcatlon Committee 

T. D. CROTHERS, M.D.. 



QUARTERLY JOURNAL OF INEBRIETY 

T. h. STEDMAN, M.D., 

MEDICAL RECORD 

H. M. SIMMONS, 

MARYLAND 



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tCatile of Contents 



ProceedingB of the Fortieth Atinnal Meeting of the American Medi- 
cal Editors' Association. Business Session 7 

Some Danx^r Signals in Jonmalism (President's Address). Bj T. D. 

Crotbers, M.D 16 

On Certain Aspects of Medical Jonrnalism. B7 David Watsh, M.D., 

F.R.C.S a?. 

The Development of Medical Jonrnalism in America. By H. O. 

Marc;. M.D 37 

Medical Boole Reviews. By Jamea P. Warbasse, M.D 46 

Editorial Revision of the Titles of Medical Papers. By F. H. 

Garrison, M.D 5j 

Medical Journal Technic. By A. S. Burdick, M.D 61 

Esperanto in Medicine. By K. W. Millican, M.D 70 

What is the Fntnre f By W. C. Abbott, M.D 86 

In Jonrnalistic Confidence. By William Porter, M.D 91 

The Response from the Reader. By W. A, Wangb, M.D 91 

Organization Medical Jonrnalism; the Trend in Medical Jonmals. 

By C. F. Taylor, M.D 95 

Therapeutic Scepticism in High Medical Places and its Popular 

Harm. By C. H. Hnghes, M.D loi 

Journalistic Insight. By M. M. S. Johnstone, M.D jo6 

Making the Public Partners in the Truths of Medical Science. By 

T. G. Atkinson, M.D 108 

The Queation of Abstracts. By Hearicb Stern, M.D 113 

The Editor and His Editorial. By W. H. Neilson, M.D 119 

A Journalist's Brief Consideration of Libel. By J. J. Taylor, M.D, im 

Individuality in Medical Journalism. By J. M. French. M.D 129 



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Zbc Emetican ^ebical JSbitote' 
Essociation 

PROCEEDINGS OF THE FORTIETH 
ANNUAL MEETING 

BUSINESS SESSION. 

The meeting was called to order by President T. D. 
Crothers, of Hartford, Conn., at the Marlborough- Blenheim 
Hotel, Atlantic City, N. J., June 5th, at 2.30 P. M. In his open- 
ing remarks President Crothers said: 

"We are on the threshold of our Fortieth Annual Meeting. 
This society is going into history as one of the most in^jortant 
associations of our day in this country. Having been through 
our periods of tempest, sun, and rain, we are still alive with 40 
years of experience behind us. 

"Strange as it may seem. America is the very first country to 
form an Editors* Association. Last year we had an exceedingly 
interesting meeting under the guidance of Dr. C. F. Taylor and 
this year I hope we will have an equally instructive one." 

The first order of business was the reading of the minutes 
of the 39th Annual Meeting, held in Chicago, which were ap- 
proved, and then followed the report of the Secretary, Dr. Mac- . 
Donald. 

REPORT OF THE SECRETARY. 

On this occasion, it would seem fitting that your Secretary, in 
his report, should present a resum^ of the history of this Asso- 
ciation for the past 40 years, but the long programme of instruc- 
tive and interesting papers shortly to follow and the brief time at 
our disposal,, precludes but a mention of some features that I 



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8 THE AMERICAN MEDICAL EDITOR'S ASSOCIATION. 

have abstracted from my paper, "The Editors' Association, Past, 
Present and Future," which appeared in full in our Proceed- 
ings of the 1907 meeting. I am sure it will prove a source of 
gratification for our present members to know the important ad- 
vances in medicine this Association has promulgated and sup- 
ported. 

This Society was organized in May, 1869, at New Orleans, 
La., and among those articles of the Preamble, which this Society 
in its early stages and in fact ever since has worked and stood for 
are: 

1. "In urging with hearty concert, improvement in the 
present system of medical education and a higher standard of 
preliminary education of those who desire to enter upon the study 
of medicine." 

2. "The collection of the names of all the regular physi- 
cians of the United States, age, place and date of graduation if a 
graduate." 

The meeting of 1871 was devoted principally to the Com- 
mittee reports with the adoption of the following resolution: 

3. "The social, e^ducational and scientific side of the profes- 
sion would be greatly promoted by a more complete organization 
in every State and district in our country. Such organizations 
being calculated not only to elicit but diffuse knowledge and also 
to afford the most efficient means of promoting concerted action 
on all important questions of medical education and progress." 

It is of particular interest to note that this resolution of the 
organization of the medical profession into County and State 
Societies, had its birth in this Association, and it has always 
been the pleasure of the Editors of the independent journals to 
further a legitimate medical organization. 

In accordance with one of the objects of the organization, 
referring to a compilation of a list of regular practitioners, Dr. 
J. M. Toner announced at this same meeting in 1871 that "as a 
result of his work, he was in possession of 50,000 names of 
medical men, which list was at the disposal of this Society." I 
believe that this was the first effort ever made to compile an au- 
thentic list of the medical men of this country. 

The meeting in 1876 was devoted exclusively to the reading 
of papers, advising a higher standard of requirements for ad- . 
mission to the profession, the outcome of which was a resolution 



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PROCEEDINGS OF FORTIETH ANNUAL MEETING 9 

advocating and advising a three-years' course in medicine, and 
endorsing a preliminary entrance examination for students. Here 
again we have the birth in this Society of an important step in 
medical education, not only the advancement from two to three 
years in medical study, but the requiring of a preliminary entrance 
I ■ B^'illlmation for students. 

In 1878 Dr. J. C. Gray of Utica, N. Y., at that time Presi- 
dent, presented as his presidential address, a paper upon "Lunacy 
Laws," endorsing and advocating a change of the statutes gov- ■ 
eming the management of the insane by our public institutions. 
As a result of the agitation created by his address and the hearty 
support given it by the medical press, many changes were made 
in the laws of the various states, in accordance with the sug- 
gestion embodied in his paper. 

Again in 1879 a resolution was introduced as follows : "We 
Condemn the Advertising of Nostrums and Patent Medicines." 

To briefly impress Upon you and place before you in chrono- 
logical order the initiative this Society has taken in shaping the 
policy of the medical profession as an organized body and its 
influence for the elevation of medical standards, I would men- 
tion first : 

1. The effort to elevate the standard of preliminary educa- 
tion for those desiring to talie up the study of medicine. 

2. The necessity for a comprehensive list of the names of 
practitioners with their schools and date of graduation. 

3. The State and District Organizations. 

4. Agitation for a three-years' course at medical colleges 
and a preHminary entrance examination for students. 

. Changes in our lunacy laws regarding the handling of 
Sies of our public institutions. 
(i. Condemnation of nostrums and patent medicine adver- 
' tising. 

As we turn the pages of the past and observe the names of 
those who were foremost in shaping the teaching and the prac- 
tice of medicine in America, we cannot refrain from mentioning 
one of the many illustrious ones who have gone before. 

Dr. N. S. Davis, one of the organizers of this Society, and 
its first President. He was the editor of the Chicago Medical 
Examiner; was recognized as a famous teacher and also as the 
father of the American Medical Association. To his memory 



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10 THE AMERICAN MEDICAL EDITOR'S ASSOCIATION. 

should we pay homage upon this the 40th A^iniversary of our 
Association. 

From a small society founded in 18C9 with\a membership 
of 22 earnest and energetic workers, this organizatSpn has grown 
until now we number 184 members, plus those nameStpassed by 
the Executive Committee and if elected will give us a toJSi! 
bership of about 800 and wherein will be found editorial repre- 
sentatives of nearly every medical journal in America. 

The progress of this Society in the past seven years has been 
somewhat phenomenal, for while in 1902 we did not represent 
many more in number than the original organizers, namely 22, 
to-day we stand as an organization of over 200, and I attribute 
this increase in our Association to the fact that the dominant fea- 
ture has been our large and attractive programmes of interesting 
papers presented in preference to the absorbing prominence given 
to the banquet of this Society in the past, as well as the need of 
organizati(»i of independent medical journals. 

While the future will not give us the rapid increase in mem- 
bership as in the past, it should assure annual meetings of absorb- 
ing interest, and if we hope to prc^ess, we must receive the 
support of every member of this Society not only by their pres- 
ence and contributions at our annual meeting, but a prompt pay- 
ment of annual dues. 

In your Secretary's report of last year, reference was made 
to uncollected dues. This report will be made this year under 
the Treasurer's report. In 1908 a reference was made t^ one of 
our Past Presidents, Dr. J. C. Culbertson and your Secretai^ -.^ 
instructed to express to the family regrets that tht doctor v 
such a depleted physical condition. It is with : ^^ 
record that at about the time you instructed your SecWKy ° 
convey our sympathy to the family. Dr. Culbertson passed a 
and is now numbered among the majority. 

As per the minutes of the last meeting, this .-.ssociation 
adopted an official button and the same has been ordered accord- 
ing to the directions and are now on sale by the Secretary. It is 
the desire of the Officers and Executive Committee that every 
member of this Society equip himself with an official button. 
Respectfully submitted, 

JOS. MACDONALD, JR.. MD., 

Secretary. 



that I 



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PROCEEDINGS OF FORTIETH ANNUAL MEETING 11 

On moti<>ii of Dr. H. O. Marcy, which was properly sec- 
onded, the Secretary's report was accepted. 



The Treasurer's Report was next called for and read and 
the President appointed Dr. F. C. Taylor, Dr. A. S. Burdick 
and Dr. William Porter as Auditing Committee, who at a later 
session reported favorably upon the Treasurer's Report and the 
financial condition of the Association affairs. 



PROPOSAL FOR MEMBERSHIP. 

The following names were presented by the Secretary for 
membership into this Association, after having been passed upon 
by the Executive Committee : 

Dr. C. A. Bryce, Editor. Soulhern Clinic. Richmond. Va. 
Dr. E. J. Doering, Editor, Medical Recorder, ChicE^o, Ills. 
Dr, F. B. Donoghue, Editor, Annals of Gynecology & Pediatrics, Boston, 

Dr. S. Harris, Editor, Gulf Slates Journal of Medicine & Sui^ery, Mobile, 

Ala. 
Dr. Oscar Hasencamp, Editor, Toledo Medical & Surgical Reporter, 

Toledo, O, 
Dr. E. B. Hill, Editor, Denver Medical Times, Denver. Colo. 
Dr. Pitts Edwin Howe, Editor, Journal of Therapeutics & Dietetics, 

Boston, Mass. 
Dr. D. A, Campbell. Editor, Maritime Medical News. Halifax, Nova 

Scotia. 
Dr. D. S. Lamb, Editor, Washington Medical Annals, Washington, D. C. 
Dr. E. Reissman. Associate Editor, American Journal of Surgery, New 

York. 
Dr. A- L- Russell, Associate Editor, Medical World, Midway, Pa. 
Dr. Jno. K. Scudder, Editor. Eclectic Medical Journal, Cincinnati, O. 
Dr. H. C. Tinkham, EJlitor, Vermont Medical Monthly, Burlington, Vt. 
Dr. W. H. Walters, Editor, New Eng. Med'l Gazette, Boston, Mass. 
Dr. Chaa. S- White. Editor, Washington Medical Annals, Washington, D. C. 
On motion of Dr. J. J. Taylor which was properly seconded, 
the Secretary was empowered ta cast the ballot for election of 
the list of proposed members. The following resignations were 
received : 

Drs. John V. Shoemaker, 
H. Augustus Wilson. 
Herman Knapp, 
Edward P. Carter. 
' S. C. Stanton. 

' = A. B. Kanavel. 



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13 THE AMERICAN MEDICAL EDITOR'S ASSOCIATION. 

Chas. G. Cumston. 
H. M. Rich. 
DeWitt C. Wilcox. 

Among these there was also a letter of resignation re- 
ceived from Dr. James Evelyn Pilcher, former President of this 
Association. Upon the reading of this resignation. President 
Crothers remarked: "This letter from one of our former Presi- 
dents, Dr. Pilcher, is certainly sad. To gradually lose sight of 
the world is indeed a hard fate, but his sympathy is still bound- 
less and he has taken thought to write us when he says, He can- 
not even see what he is writing." 

Remarks by Secretary MacDonald : "Dr. Pilcher has been 
one of our most active workers. Prior to his office as President, 
he was always ready and willing to read a paper and do every- 
thing he could to help make our meeting successful and interest- 
ing and I would like to introduce a motion that Dr. Pilcher be 
made a life member of this Association without dues." This 
motion was seconded and carried unanimously by a rising vote 
and the Secretary was directed to convey to Dr. Pilcher the action 
of this Society and convey to him our great sympathy in his 
affliction. 

REPORT OF PUBLICATION COMMITTEE. 

The President called for the report of this Committee and 
in the absence of the Chairman, the Secretary stated, "that a 
number of pieces of literature had been sent out to the various 
members, but little attention was paid to these communications." 
As a result of this lack of attention two members of the Associa- 
tion purchased additional copies of Transactions and Dr. Abbott 
maintained that the literature from the Publication Committee 
had never reached his office and seemed to question the distribu- 
tion of the material, however an acknowledgement of its receipt 
by a number of members present led the Committee to believe 
that its non-appearance in the pages of our journals was due pri- 
marily to an oversight. 

A letter was received from First Vice-President, Dr. W. A. 
Young, regretting his inability to be with us on account of his 
absence in Europe and expressed his best wishes for a successful 
meeting. 



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PROCEEDINGS OF FORTIETH ANNUAL MEETING 13 
CHANGE OF BY-LAWS. 

At the Chicago meeting a resolution was introduced to 
change Section 1, Article 3 of our By-Laws regarding; the admis- 
sion of members, and a Committee was appointed with Dr. 
Abbott as Chairman, who reported the suggested amendment as 
follows : 

Article 3, Section 1 : "Eligibility to membership in this Asso- 
ciation requires that the applicant or member shall be actively 
engaged in literary work in connection with some medical journal 
or scientific bulletin conducted along lines of unquestionable edu- 
cative value to the profession," On account of the importance 
of this change in Article 3, Section 1, it was freely discussed by 
Drs. Taylor, Abbott, Hughes and others, and on motion of Dr. 
C, F. Taylor, the amendment as above introduced was adopted. 

ADVERTISING IN MEDICAL JOURNALS AND LAY 
PUBLICATIONS. 

A Committee was appointed to present a resolution for adop- 
tion by this Association, conveying an opinion of what articles 
should be suitable and allowable to be advertised in lay publica- 
tions as well as in medical magazines. This Committee was ap- 
pointed at the Atlantic City meeting in 1907. Dr. C. H. Hughes 
was Chaiiman and presented the following resolution: 

"It is the sense of this Association that no medical prepara- 
tions advertised in the secular press other than foods, dietary 
articles, external antiseptics or medicines for external use or 
appliances be a proper subject to be advertised in medical jour- 
nals." 

This resolution was discussed with much interest and enthu- 
siasm by 

Drs. C. F. Taylor, 

C. S. Chamberlin, 
J. MacDonald, Jr., 
Wm. Porter, 
W. C. Abbott, 
and on rising vote, the resolution was unanimously carried as 
introduced by Dr. Hughes. 



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14 THE AMERICAN MEDICAL EDITOR'S ASSOCIATION. 

The President appointed the following members as Nom- 
inating Committee: 

Drs. C. F. Taylor, 

William Porter, 
D, O. English, 
and their report to the Association for the following officers was 
accepted and they were dujy elected. 

W. A. Young, M. D., President, Toronto, Canada. 
W. A. Jones, M. D., First Vice-President^ Minneapolis, 
Minn. 

M. M. S. Johnstone, M. D., Second Vice-President, Chi- 
cago, III. 

J. MacDonald, Jr., M. D., Secretary and Treasurer, New 
York. 

EXECUTIVE COMMITTEE: 
J. J. Taylor, M. D., Chairman. 
W. C. Abbott, M. D. 
C. L. Stevens, M. D. 

PUBLICATION COMMITTEE: 

T. D. Crothers, M. D., Chairman. 

T. L. Stedman, M. D. 

H. M. Simmons, M. D. 

Dr. J. J. Taylor requested Dr. Hughes to take the chair and 
introduced a resolution of appreciation and thanks to Dr. T. D. 
Crothers, our retiring President, for the excellent work he had 
done to make this meeting such an unusual success. This resolu- 
tion was unamimously adopted by a rising vote. 

Dr. Taylor further remarked : "Only those who have been 
close to Dr. MacDonald know the enormous amount of work he 
has done and the self-sacrifice entailed to render us the efficient 
services which he has. I feel that wpre it not for the work that 
Dr. MacDonald has done, we would not have had the success we 
have had. I therefore move a resolution of thanks' which is the 
only remuneration he has set for his efforts during the past year." 
Carried by rising; vote. 

Dr. W. A. JoneSj First Vice-President, by a few well-chosen 
words acknowledged his appreciation of the honor conferred upon 
him. A vote of appreciation was given the Proprietors of the 
Hotel Marlborough- Blenheim for their courtesy to the members of 
our Association. Also a vote of thanks was extended to the fol- 
lowing concerns for favors extended to us which were much 



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PROCEEDINGS OF FORTIETH ANNUAL MEETING 15 

appreciated : Geo. Kessler & Co., Hiram Dewey Sons, The Apol- 
linaris &>. and E. P. Coby & Co. 

On motion tiie meeting adjourned to meet upon call of Execu- 
tive Committee. 

THE ANNUAL BANQUET OF THE EDITORS' ASSO- 
CIATION. 
Was Held in the Chevy Chase Room of the Marlborough- 
Blenheim Hotel. While this Society has had many social dinner 
events, this one on account of our 40th Anniversary was unusu- 
ally well attended and the speeches were brilliant and interesting. 
A souvenir menu, reproducing the likeness of the officers of the 
Association and the 17 living past Presidents, was a feature and 
a valuable souvenir of the occasion. 

President Crothers presided as Toast-master and the following 
responded to toasts. 

"Memories of Earlier Days" 

Henry O. Marcy, M. D., Boston, Mass, 

"How to roar as gently as a Suckling Dove" 

Frank Woodbury, M. D., Philadelphia, Pa. 

"The Public Health" 

Walter Wyman, M. D., LL.D. 

Surgeon General, Public Health and Marine Hospital Service. 

"Just Talk" 

Walter M. Brickner. M. D., New York 

"The Doctor in the Tropics" 

Col. William C. Georgas, U. S. A. 

Panama Canal Commissioner 

"Editorial Suggestions" 

William Porter, M. D., St. Louis, Mo. 

"The Relation of Medicine to Law" 

Judge Robert H. Ingersoll, Atlantic City 

"The Nervous vs. the Maxim System as applied at Monte Carlo" 

C. H. Hughes, M. D., St. Louis, Mo. 

"Why are my Monthly Talks Never Read?" 

C. F. Taylor, M. D., Philadelphia. 

"Dixie" 

Raymond B. Wallace, M. D., Chattanooga, Tenn. 

At an appointed moment the members standing drank a toast, 

"A pleasant journey and a safe return" to our President-elect W. 

A. Young, M. D., of Toronto, who was in mid-ocean on his way to 

the International Medical Congress. 



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PAPERS. 



SOME DANGER SIGNALS IN MEDICAL JOURNALISM. 
pkesident's address. 

By T. D. Crothers, M. D., Hartford, Conn. 

Editor of "Journal of Inebriety." 

THE 40th anniversary of this Association brings with it an 
historical retrospect of the most fascinating interest, as well 
as some significant forecasts of the possible perils of the 
future. 

The faith and enthusiasm of the little group of men who 
organized this Association has been amply justified, and during 
its long history nearly every medical editor in America has been 
a member of this Association, and many of them active con- 
tributors in developing its interests. 

The central object and purpose, to combine and increase the 
interests of medical journalism, to bring its editors and managers 
into closer relations, and establish some general rules of reciprocity 
and mutual aid, has been accomplished, to a very large degree. 

A history of this period and its active workers will be pre- 
sented by others. My purpose is to outline some present con- 
ditions of journalism, and call attention to the obvious perils 
which we all recognize, and make forecasts of the future. 

Medical journalism, at the first, was independent, addressing 
its work to the general practititmer, and aiming to give a sum- 
mary of all the advances in general medicine, and outline the 
theory likely to be most practical. , 

This form of journalism sought to be helpful to the general 
practitioner, appealing to him for support, and to accomplish this 
it must build up a distinct personality and popularity that would 
be attractive. A few years later special journals appeared, having 
for their object the presentation of particular studies of separate 
branches of medicine. 

These journals have grown into popularity and occupy a 
very important field that grows wider as the years go on. As 
medicine becomes specialized, these journals are required to 
give prominence and concentrate special studies on special topics 



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T. D. CROTHERS, M. D. 17 

and methods of practice in particular departments of medical 
science. 

These journals enable the specialist to keep in touch with 
the most advanced studies and facts in particular directions. 
They are addressed to appreciative readers, who read with eager- 
ness the latest* facts and theories and receive genuine inspiration 
from it. 

Thus, every year .technical medicine and technical studies 
must be separated and published in journals devoted to this par- 
ticular work. Exhaustive studies of some particular field of 
medicine have no place in the general journal, except as a brief 
summary, and ambitious authors who reason that excessively 
technical papers appeal to general readers and impress them are 
mistaken. 

In reality, it is largely lost. If their productions are to 
appear in a general journal, it should be popularized and sum- 
marized to be of value. General journals lose much of their 
influence by publishing contributions which belong to special 
fields of medicine in full, when they should only be summarized. 

Recently society journals have come into prominence. They 
are a curious combination of the general journal and the spe- 
ciahsts' organs, and often rqiresent neither, but are rather of 
the transactions style publishing everything offered, and the 
readers taking their choice as to what is good or bad for them. 

Such journals, while certainly great educational forces, stim- 
ulating the writer and reader, soon develop into practically stock 
companies, in which the subscribers are stockholders and owners 
of the journal, and its management depends on organization and 
concentration of effort. 

The larger the journal, the more diversified the interests 
and the greater the difficulty to secure harmonious effort and 
union of organization. 

The financial world furnishes many examples of great trust 
efforts to combine and control affairs of the world which have 
carried along the elements of its own destruction, and sooner or 
later dissolved. The very diverse interests of American civiliza- 
tion, and particularly of physicians, cannot be confined and 
made to work along any mechanical lines of organization. 

There is too much democracy and independence, and scieiKe 
is too uncertain in its conclusions and facts to be harnessed 



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18 SOME DANGER SIGNALS IN MEDICAL JOURNALISM. 

down to a uniform system of activity. Independent journalism 
appealing to its subscribers' individually, and bringing with it 
capacity and merit to supply their diversified wants, is the great 
normal, natural growth of medical literature. 

Special journals appealing to specialists are independent in 
the sense of addressing a particular audience with a particular 
line of facts which the reader is more or less familiar with 
They are on the frontiers of medical journalism and literature. 

The 125,000 physicians in the United States appeal to 
journalism to keep them posted and in touch with the rapid ad- 
vances of science, and this demand calls for journalism that is 
independent, that represents science in general or special studies 
in particular. 

The subscription list is the barometrical index of how far 
the journal supplies this great want, and the more independent 
the journal, the greater its freedom in presenting the facts of 
scientific advance. . A special journal is confined to a special 
topic. A society journal should and must represent the interests 
of the society, and independent journals represent the subscribers 
and their interests in the largest way. 

While we are all familiar with the frequent criticisms con- 
cerning journals and books, yet there is a general agreement that 
medical literature in this form is developing and evolving from 
lower to higher standards yearly. 

There are forecasts, intimations and unmistakable signs of 
a broader journalism, clearer and more exact text-books and a 
movement which should be our highest pleasure to assist in 
every way. The increase in the number of medical books during 
the last 10 or 15 years presents very significant signs, not only 
of this movement, but indications of change and revolution, and 
new points of view, unsuspected before. 

Bitter acrimonious criticism, and dogmatic condemnations 
never help any cause or destroy any evil, but, as a rule, reacts 
on the critic. The great question is how to develop journahsm, 
how to overcome its weakness and increase its value, and what 
conditions or causes hinder the development and retard the ef- 
forts and struggles towards better literature and better journals ? 

Recent scientific advances show from laboratory and clinical 
research that much of the weakness and failures depend on the 
mental condition and physical vigor of individual editors and au- 



)vGoo'^lc 



T. D. CROTHERS, M. D. 19 

thors. This is evident everywhere in the poor work, stupid blun- 
ders of highly trained excellent men, which, of course, is due to 
impaired brain and nervous vigor. 

In the great conflicts of science it often happens that men 
most healthy and vigorous do far better work and surpass their 
rivals who are superior In culture and technical training. It is 
evident that physical causes are a very important character, enter- 
ing very largely into the production of poor books, weak journals, 
foolish unreasonable misconceptions of facts and their meaning. 

The wide variations in editorial work, and the management of 
journals and the faulty discrimination and reasoning concerning 
facts, are due to special physical causes. Both books and journals 
show this in their tone and quality, and great diversity of the treat- 
ment of subjects. 

Thus in one part of a book there are many strong, clear 
conceptions of facts. In another the facts are weak, confusing 
and badly grouped. One is continually surprised in examining 
books which have recently appeared, devoted to general or special 
medicine, which contain so little that is new or well stated. 

The number of books published during the last ten years runs 
into the thousands, and yet literally very few of them can be called 
contributions to science, or even good statements of well-known 
facts. It has been said that the quality decreases with the increase 
in number. 

In some respects this is true. Any careful psychological study 
of medical literature, either in journals or books, show not only the 
knowledge of the author, but his health and vigor at the time of 
writing, and very often this is the most prominent feature of the 
book. 

Many books exhibit the strained efforts of a tired, overworked 
brain, depending on chemical help from spirits and drugs, or a 
worn-out brain needing rest and out of tune ; or a nervous system 
buoyed up by tobacco, coffee or spirits, working at midnight with 
increasing feebleness and confusion. 

Some of the encyclopediac works furnish illustrations, where 
a number of authors write on different phases of the same sub- 
ject, and the editor's eifort to bring them up to some standard of 
clearness fails to cover up the weakness, and the strained mental 
conditions in which the work was produced. 



)vGoo'^lc 



20 SOME DANGER SIGNALS IN MEDICAL JOURNALISM. 

It is not the author's lack of knowledge, but it is the mental 
disability to group the facts into clear outlines that indicates his 
impaired health. Often books indicate, not only the youthfulness 
of the author and his limited practical knowledge, but his strained 
efforts to compile and change the writings of others, and give 
them a personal setting which is very largely the result of chemi- 
cal aids that are apparent in his use of words. 

Text-books by college professors and teachers are good illus- 
trations of the strained conditions and feeble mentality and the 
caffein, tobacco, spirits relied upon to produce them. Recently 
a learned teacher excused himself at a dinner at ii P.M., saying 
he must go home to work on a text-book. 

When that books appears it will bear all the signs of his 
mental condition and drafts on his reserve forces to produce it. 
We are all familiar with the disappointment of popular teachers 
and writers at the cold reception of their books. 

Bitter complaints that his book did not sell, owing to rivalry 
or the failures of some of the publishers, are frequently heard, 
and occasionally an editor will give an extravagant review of the 
book, but even that fails. The book is dead, or practically mori- 
bund. 

In reality such works are by-products, fashioned at midnight, 
grown out of alcohol, tobacco, cocaine or coffee. They lack the 
ring of clearness and vigorous conception, although the author is 
a good man. These facts are seen in journalism, both in the con- 
tributors and among editors. The irritability of editors is always 
a significant sign. 

His pessimism is pathological and his fault finding is equally 
suspicious. Editorials that are involved, negative, obscure or 
intensely personal suggest a great variety of causes. 

Often we are astonished at the wide variation between the 
work of a contributor or an editor, and his personal bearing and 
social appearance. They represent two different types that do 
not seem to have any relation to each other. 

A very good illustration of the ill-health and toxeemic condi- 
tions of editors and contributors has been seen in the medical com- 
ments on psychotherapy, the Emmanuel Movement and some of 
the popular topics that have occupied public attention during the 
year. 

The dogmatic assertiveness, the suspicion, the credulity and 



jvGoO'^lc 



r. D. CROTHERS, M. D. 3X 

the misconceptions, with feeble reasonings and childish explana- 
tions, and the absence of scientific judgment and conservatism, 
seen in these varioi^s writings are all unmistakable indications of 
low physical vigor, toxic fatigue, defective brain and nervous 
system. 

Some of the comments and papers were so badly done, and 
such poor work, that it would appear that the author needed the 
very treatment that he attempted to condemn. Another very in- 
teresting outlook is seen in the frequent discussions of the tuber- 
culosis problems. 

Here another phase is seen. Many of the authors were obvi- 
ously suffering from this disease, and wrote under the influence 
of drugs and remedies. In this there was a peculiar delusive ex- 
altation of tone and statement, and failure to make a proper pros- 
pective of the thou^t, massing facts in one direction, and ignor- 
ing them in another, leaving a picture that represented their own 
condition, more than that of the disease, and through it all con- 
siderable evidence was apparent of the drugs that they were 
using. 

The literature which comes from this class made up of stories, 
statements, appeals and imaginative reasonings have the ring of 
inspiration from spirits, drugs, coffee and other agents. Consid- 
erable general literature, some of it quite popular, has the un- 
mistakable evidence of the author's condition and his forced prod- 
ucts. 

The ordinary contributions to the medical journals, which, 
as a rule, are either written by very practical, earnest men, ac- 
tively engaged, or by young men with little or no practice. In 
the former there is evidence of the health of the writer, and his 
conceptions of the subject. 

In the latter the scrap-book compiling ability and his knowl- 
edge of literature fashioned af,ter some bot^ or particular reading. 
A psychological study of the orations and addresses before medi- 
cal societies by very good men brings out the same fact. 

Often these addresses were written at different times with 
intervals between the parts, and here the same ill-health, mental 
confusion, feebleness of reasoning is apparent. 

In some addresses the author was evidently under the influ- 
ence of spirits or cocaine or some other drug, not that he was a 
victim of these addicttions, but he had used these drugs for the 



jvGoO'^lc 



28 SOME DANGER SIGNALS J-\ MEDICAL JOURNALISM. 

emergency, and with an idea that it gave him fluency and clearness. 

In reality it showed unmistakable traces of faulty work. In 
one widely published address there was a very clear opening and 
statement of the facts followed by a confused grouping of princi- 
ples with an involved presentation of minor questions, and then a 
return to the main facts with clear, broad outlines, and finally 
ending in a peroration that lacked direction and point, and started 
out clearly, but ended in confusion and mist. 

This was a reflection of his mental fatigue and condition at 
the time. It is a curious fact that muscular exertion up to the 
point of fatigue is recognized as requiring rest for restoration, 
but brain and nerve fatigue are often regarded as a condition 
which can be overcome by chemical agents, drugs and superficial 
means other than rest. 

If sleep does not follow when required it is forced by chemi- 
cal means, and if the brain shows weakness and irritability, food 
and fluid with drugs are supposed to restore the lost energies. 

The signs of impaired mentality seen in irritation, nervous- 
ness and weakness are easily recc^ized, but when they are ex- 
pressed on the printed page they attract no attention other than 
that the author is not at his best. 

Often editors and authors underrate their weakened condition 
and debility, and believe that it is a matter of will-power which 
can he overcome by stimulants and drafts on latent energies. 

When a certain work is to be done, the idea is that the mind 
and body can be forced by a call on the reserve forces and out- 
side aids to accomplish this purpose, irrespective of apy present 
conditions. 

The fallacy of these delusions is apparent in literature, both 
medical and secular, and no books or journals can be produced 
that will rise above the mental health and vigor of the author. 
Brain and nerve fatigue, indigestion, bad diet, faulty living and 
bad surroundings, appear in literature and make it impossible to 
do anything more than mediocre work. 

Teachers in colleges, active surgeons and practitioners, doing 
professional work that is absorbing, suffer impairment of their 
ability to do active literary work. Afteria day of great activity 
and professional work, to write books, editorials and decide On the 
value of literary productions is to draw on reserve powers already 



)vGoO'^lc 



II 



r. D. CROTHERS, M. D. 23 

exhausted, and fail, and leave the evidence of failure in the work 
done. 

The author's mental condition is stamped all over the printed 
page. Very interesting- reflections of this fact are seen in the 
work of prolific authors, particularly in the wide variations of the 
quality, tone and clearness. 

Secular journalism presents very startling examples of im- 
paired vigor and mental health, and some books show the effects 
of cocaine, coffee, spirits and opium so clearly that an expert is as 
positive of the habits of the writer as if he had seen him person- 
ally. 

Medical men as a rule are not literary men in the sense of 
using the imagination and philosophic reasonings from abstract 
basis. They are largely reporters of facts and their meanings, 
but even here there are the strange faults and unexplained feeble- 
ness and brilliancy. 

Sometimes acrimony and bitterness is displayed and hysterical 
emotionalism on matters of small moment. Often authors write 
but one article or book that indicates vigor and clearness. After 
that there is a continuous decline. 

Recently some studies of the effect of diet in literary work 
have called attention to the fact that the peculiarities and eccen- 
tricities of authors are dependent on the toxasmic conditions from 
excess of carbo-hydrates or protoid foods. 

This is indicated by the oft-repeated statement that the writer 
is bilious and t's constipated, and his thoughts take form from 
these coiteiitioUs. 

In an instance under my care a medical man who was a 
brilliant writer suddenly became stupid, confused and irritable. 
In reality he was a gormand. When he changed his habits of life 
and lived hygienically his former brilliancy returned. 

There can be no question that indiscriminate eating and reck- 
less disregard of the ordinary hygienic rules of nutrition makes a 
pronounced impression on the literary work, and the scientific 
judgment of the author. 

The term paranoia means literally a mental twist or a diver- 
sion of the brain from normal functional activities. Such a term 
would describe medical work and medical writings very clearly. 
This form of mental defect is frequently marked by the delusion 
that mental work of any kind can be promoted by foods, spirits 



)vGoo'^lc 



34 SOME DANGER SIGNALS IN MEDICAL JOURNALISM. 

and drugs, and that it is possible to bring the brain to a high 
degree of vigor at all times by these agents. 

This delusion is based <on physical causes, which should be our 
province to recognize and to overcome, and with it all to exercise 
more charity towards the mistakes and blunders which we deplore. 

Any forecasts of future journalism must take into considera- 
tion the larger knowledge and better concepticm of mental hygiene 
and its practical appHcation in the every-day life of journalism 
aqd book work. 

We are all conscious that we could do better work, that better 
books are called for; and the question is, how can we overcome 
the causes and raise the standard of clear recognition and ex- 
pression of the facts. 

The profession everywhere will support and sustain better 
journals and buy better books. They are looking for them, and 
it is certain that they will come, and it is our highest effort to 
supply this demand. 

Obviously, there is only one way to accomplish this ; by giving 
greater attention to personal and mental hygiene, to cultivate and 
develop the highest degrees of health and vigor possible. This is 
what will show in the printed page and in our work. There is no 
justification in the theory that spirits, drugs, caifein, tobacco, 
cocaine or any substance of like character have only temporary 
and transient injurious effects on the brain and nervous system, 
and that they may be taken in emergencies to draw out new forces 
and energies without loss or impairment. 

On the contrary, all evidence indicated beyond question that 
any or all of these drugs inipress and diminish the normal work- 
ings of the brain and nervous system, and this impainnent is seen 
in the work of journalism and the writing of books. 

There is no justification in the common belief that the indis- 
criminate use of foods and reckless diet have little or no deroga- 
tory influence on the highest mental vigor and strength; or that 
nature will repair and overcome excesses of this kind, and that 
good mental work requires excessive foods to supply the loss of 
energy. 

On the contrary, the best teachings of science show that the 
indiscriminate use of carbo-hydrates, proteids and other articles 
of food impair the efficiency and vigor of the brain and favor the 



jvGoO'^Fc 



T. D. CROTHERS, M. D. 25 

production of toxic agents which injure and destroy the capacity 
for healthy mental work. 

There is no justilication for the belief that brain strains are 
not more serious than muscular strains, and that fatigue of one 
is practically the same as the other, and that recovery will take 
place more rapidly in the brain than elsewhere. 

On the contrary, the activities of the brain and nervous 
systems are more complex, more easily injured and more slowly 
repaired than in any other organ. 

The nutrition of the brain is specifically influenced by the 
quality and quantity of the food, and it is far more sensitive to 
derangements from toxins and chemical agents, and its restoration 
is not accomplished by chemical agents of any kind, but only by 
rest and change. 

Finally in the slow evolutionary march of medical journahsm 
and medical literature, everything depends, and turns, on the vigor 
and health of the brain and nervous system of the workers. 

Scholastic training, culture and large knowledge is all second- 
ary and superficial, compared with physical health, living close to 
nature and the exact observance of its inexorable laws. 

The journals that we edit and the books that are written are 
only transient, and but for the day, unless they come from the 
cTeiarest sanest and most healthy activity of the brain and nervous 
system. 

Thus the forecast of the future indicates no great advance 
unless we have a revolution in our present methods of work and 
a return to the production of the highest kind of physical and 
mental vigor by extraordinary care in the conditions under which 
we labor to procure the very best possible products of our brains. 

One fact should never be lost sight of, namely, our feebleness 
and weakness, strength and vigor, goes down on the printed page 
and all unconsciously gives immortality and mortality to all that 
we do. 

DISCUSSION ON DR- CROTHERS' PAPER. 

W. C. Abboll—l would just like to say something anent the remark 
that no organization journal has recognized our association. Dr. English 
in his last issue has a very commendatorj' little item welcoming us to the 
meeting. 



jvGoo'^lc 



26 SOME DANGER SIGNALS IN MEDICAL JOURNALISM. 

C. H. Hughes — If there are no further remarks I would like to say 
a few words on that paper myself. I think without disparagement to 
the many other papers, this is the most important paper we have had read 
here today. This is the only paper that takes into consideration the fact 
that a correct physiological, psychological state is necessary to proper 
mental work. It recognizes the cerebro-psycho logical make-up of a man. 
Medical editors as well as editors of lay journals write too many editorials 
too late in the day and many of them as Dr. Crothers has suggested imder 
the influence of artificial stimulants to support nature. A great many 
papers and medical books are written, as the author tells us, after a hard 
day's professional work when the author should be enjoying his much 
needed rest. This is hardly creditable to the man who makes the statement 
that his books are written after twelve o'clock at night because it is apt 
to prejudice the reader against the book. It was said in oldentjmes that 
'the night cometh when no man shall work' but in these strenuous days 
of gas and electric light we have do night and men boast that after a hard 
day's work their books are written and editorial work done. Many a time 
I have thrown aside a manuscript, waiting for a. better condition of men- 
tal attitude. In don't want to put the result of my tired brain before my 
critical editorial brothers. There is much truth in this paper. We have 
not always appreciated the fact that much of the bad literature in our 
profession and much of the unsatisfactory literature and the illegitimate 
literature of the day is the product of the over- stimulated neurasthenic 
brain that would appear to far better advantage written under different 
conditions, 

Geo. F. Butler — I think much of the bad literature is not so much 
due to over stimulation or the use of liquor as it is to the desire on the 
part of the writer to produce an enormous amount of stuiT. We are 
troubled with mental indigestion from our effort to digest the enormous 
amount of stuff ijhat is given us. It would be far better to write one good 
article a year, well thought over and carefully written, than to attempt to 
have something published every month. One good editorial, worth while, 
published in a good journal is, in my opinion, worth a dozen inferior ones. 
It is more a desire to do too much work than it is doing it under stimi'- 
lants. 

President Crothers' aliasing remarks — My desire, gentlemen, was 
f>imply to call your attention to the evident traces and signs all through our 
literature and, as Dr. Butler has said, evident mental strain, but with it all 
vou can see the evidence of chemical stimulation- 



)vGoo'^lc 



i 



DAVJD WALSH, M. D. 



ON CERTAIN ASPECTS OF MEDICAL JOURNALISM. 
By David Walsh, MD., 

SENIOR PHYSICIAN, WESTERN SKIN HOSPITAL, LONDON, W. ; PHV- 

SICIAN TO THE KENSINGTON AND FULHAM GENERAL 
HOSPITAL, ETC. 

Editor Medical Press and Circular, London, Eng. 



MR. President and Gentlemen, When first the American 
Association of Medical Editors honoured me with an 
invitation to address your annual meeting I hoped that 
I should have the> great pleasure of accepting in person 
the hospitality thus freely offered. To my regret, various cir- 
cumstances have frustrated that desire and intention, but in ac- 
cordance with the wish of your President and Council I send 
herewith a brief address dealing with a few points arising out of 
my editorial experience. In no sense have I attempted to write 
an elaborate essay upon a subject of such complexity and impor- 
tance as that of the journalism of medicine. At the same time, 
the few informal remarks I have ventured to submit to your con- 
sideration will not have failed altogether in their object if they 
reflect, however dimly, the sense of brotherly interest and of 
cordiality so gracefully conveyed in your invitation to the Editor 
of the Medkd Press and Circular, a British journal, be it re- 
marked, that has already passed by a single year the span of three 
score and ten years usually allotted to the life of man. 

The medical joumal of to-day is accepted by most of us as a 
familiar fact; but there is much in its history, as well as in its 
habits and its environment, that will repay discussion. By a 
process of specialization it has evolved into a distinct species of 
that mass of ephemeral literature which we term modem jour- 
nalism. Its characters are sharply defined. Amongst them it 
reports progress, not only at home, but also of the whole world, 
from China to Peru ; it registers the ever-changing relations be- 
tween medicine and the State ; it exposes the injurious methods 
of the charlatan, and iti a thousand other ways protects the health 
of the community; it forms a central exchange, so to speak, for 
medical views and opinions; and, lastly, it records the domestic 



jvGoo'^lc 



38 ON CERTAIN ASPECTS OF MEDICAL JOURNALISM. - 

happenings of the great professional family, of which it is in 
many senses the guide, philosopher and friend. 

But while it is true that the medical journal of to-day holds 
up the mirror to a world of wide activities, we cannot overlook 
the fact that it is a species of late development. It is emphati- 
cally an offspring of modern environment, conceived of the un- 
ceasing intellectual energy of mankind born of the printing ma- 
chine, rendered possible by the post office, and nurtured by the aid 
of a progressive profession. 

EARLY D.^YS OF MEDICAL JOURNALISM, 

The Lancet, the pioneer of medical journalism, first saw the 
light of day on Sunday, October 5th, 1823. It was issued weekly, 
at the price of sixpence, and consisted of some 30 crown-octavo 
pages. In its preface the editor says : "It has long been a matter 
of surprise and regret that in this extensive and intelligent com- 
munity there has not hitherto existed a work which would convey 
to Hie public and to distant practitioners, as well as to students of 
medicine and of surgery, reports of the Metropolitan Hospital 
Lectures." The contents of the new journal, however, were of a 
much more catholic nature than the foregoing remarks might sug- 
gest, for they included long criticisms of plays, table talk of a 
diversified nature, reports of criminal trials, general news uncon- 
nected with the profession, humorous anecdotes, and chess prob- 
lems. 

The readers of the Lancet, however, were evidently not dis- 
satisfied, for we find that after a year's existence the editor was 
able to announce that "Our success has exceeded our most san- 
guine expectations'." It is interesting to recall the fact that for 
the first ten years the Lancet "was a duelling ground for a series 
of fierce encounters between the editor and the members of the 
privileged classes in medicine." (a) At that period all the chief 
medical and surgical appointments were in the hands of a care- 
fully organized clique, who did not hesitate to stigmatize the out- 
spoken editor of the new venture as a literary pirate and a dis- 
seminator of moral garbage. The trouble did not end there, for 
in the first decade of his editorial experience Wakley was en- 
gaged in na -fewer than ten law actions, six of which were for 
libel. In these latter a sum of i8,ooo was claimed as damages, 
and an aggregate sum of £155 6s. OJ4d. was awarded, while the 



)vGoO'^lc 



DAVID WALSH, M. D. 29 

costs were defrayed for the most part by public subscription. A 
great deal of interesting information regarding the Lancet can 
be obtained from the excellent "Life of Thomas Wakley," written 
by Dr. Squire Sprigge, who has lately succeeded to the editorial 
chair. The contrast between the Lancet of 1824 and that of 1909 
is no less marked in quantity than in quality. The modest crown 
octavo of 30 pages has grown to 70 or 80 pages or more of hand- 
some double quarto, with an equal number of pages of advertise- 
ment. The Lancet is read all over the world, and enjoys a 
princely income apparently. 

The second oldest weekly medical journal is The Medical 
Press and Circular, the Dublin editor of which is Dr. H, Jellett, 
of Dublin, while the London editorship is in my own unworthy 
hands. It appeared first in 1838 as the Dublin Medical Press, 
and was amalgamated in 1866 with a small London weekly, the 
Medical Circular. The journal was then called by its present 
name ; it is of quarto size, published mid-weekly in London, and 
sold at fivepence. It has always been distinguished by a tone of 
fearless but impartial criticism, and it has lived long enough to 
see the accomplishment of many of the reforms advocated in its 
columns. 

There is no need here to do more than mention the British 
Medical Journal, with its weekly volume of scientific, literary, and 
general editorial matter. This journal, which has probably the 
largest medical circulation in the world, is under the able direc- 
tion of Dr. Dawson Williams. 

Nor is there any need to allude individually to the rest of our 
medical journals, weekly, monthly, quarterly, special and general, 
many of them no less excellent in matter than in manner. Dur- 
ing the past generation a good many such journals have come 
into existence, but not a few have passed away after a more or 
less brief sojourn upon the professional stage. The majority 
have owed their origin to some busy medical man, who has de- 
voted his spare energies to that most fascinating of pursuits, the 
creation of a modem journal. 

THE SUPPRESSION OF QUACKS AND QUACKERY. 

One of the noblest crusades that could be fought by a medical 
journal has always seemed to me to be that against quacks and 
quackery. If the mission of scientific and practical medicine be to 



)vGoO'^lc 



30 ON CERTAIN ASPECTS OF MEDICAL JOURNALISM. 

foster the health of the community, that function could hardly be 
fulfilled to better purpose than by exposing the fraudulent prac- 
tices whereby and whereon the charlatan waxes fat at the expense 
of his fellows. From the outset of medical journalism this sub- 
ject has been singled out above all others for editorial onslaught. 
It must be confessed, however, that this output of energy has not 
been hitherto attended with the success to which it is entitled. 

British law is riddled with absurdities when it comes to deal- 
ing with unqualified medical practice. Provided he does not assume 
the title of doctor, and does not actually sell medicines, any quack 
may set up as a bone-setter, a cancer-curer, a specialist in the treat- 
ment of eyes, nerves, skin or any other part of the human body. If 
an unqualified person assume the title of doctor, he can be prose- 
cuted under the Medical Acts. That oflfence, of course, it is easy 
to steer clear of, much more so, in point of fact, than the further 
offence of selling medicines, for which a prosecution may be 
brought under the Apothecaries Act. As a matter of fact, our 
Medical Acts are so badly drawn that they utterly fail so far as 
concerns the protection of the British public against quackery, 
and practically for many years past the only penal control in that 
direction has been through the limited powers conferred by the 
Apothecaries Act. There can be little doubt, nevertheless, that 
under the existing common law, apart from special Acts, a great 
deal mig^t be done to check the evil. During the past few years 
the police have successfully prosecuted a few of our most notori- 
ous quacks. The charge by means of which they have laid these 
gentry by the heels is the extremely clear and simple one of ob- 
taining money by false pretences. That method of procedure has 
been strenuously advocated for many a year in the Medical Presi 
and Circular, and in other medical journals. What we really 
want is some responsible central authority whose duty it shall be 
to prosecute all such offenders systematically and automatically, 
just as any other rogues are controlled. There must be some- 
thing rotten in a system of criminal law administration which 
sends to prison a man as a vagabond, who has no visible means 
of subsistence, or who asks for alms when he is starving, but 
which at the same time permits a quack to extract money and to 
put his victims to unutterable, and it may be fatal, pain and 
misery, on pretence of curing their maladies. With a strong 
police administration to enforce the principle that a quack, like 



)vGoo'^lc 



DAVID WALSH, M. D. 31 

Other persons, must abide by his published undertakings, and by 
his contracts, and must give proper value for money received, 
it is likely that, under such adverse conditions, this terrible evil 
of quackery would be speedily abated, if not altogether rooted up 
and cast into the fire. 

Meanwhile, the evils wrought by proprietary nostrums and 
by bogus practitioners have been ruthlessly exposed, not only by 
the medical but by several lay journals. In spite of repeated 
exposure, however, the tide of successful quackery probably 
never ran higher than it does at the present moment. Of late a 
crv has been raised for more drastic methods, and most of ail for 
that truly British forerunner of legislation, a Royal Commission. 
That instrument of State investigation is often singularly effi- 
cient in collecting facts and in educating both public and legis- 
lators as to the needs of any given case. It has been advocated 
for many years past in the columns of the Medical Press and 
Circular, and has been forcibly laid before the British Medical 
Association by Mr. Henry Sewill. That demand has been fore- 
stalled by one of our Colonies — to wit, New South Wales, which, 
in 1908, issued a monumental report detailing the results of a 
Royal Commission upon the sale of proprietary medicines. The 
official document in question must become a classic for all future 
reformers in that important field of work, more especially in the 
English-speaking world. America is concerned in this report 
almost as much as England, for quackery is ubiquitous, and, with 
the aid of the post office and the newspapers, scours the whole 
world in search of victims. One has only to glance through a 
few pages of that volume to realize the vast amount of fraud and 
cruelty inflicted upon the community by the charlatan, who is 
endless in his shifts and his trickery as he is heartless beyond 
words in his greedy cynicism. Take, for example, the brazen 
effrontery with which one firm sends out all over the world for the 
treatment of drunkenness a remedy made up for the most part of 
raw and inferior spirit. Could anyone imagine a more reckless 
defiance of the ordinary rules of ethical conduct than to sell such 
stuff under such circumstances to persons trying to break away 
frorii that very poison? The incident reminds one of the famous 
phials, said to contain blue, yellow, and white electricity, which 
some years ago were introduced by an Italian Count and sold 
extensively in the United Kingdom and elsewhere for the cure of 



jvGoo'^lc 



38 0-V CERTAIN ASPECTS OF MEDICAL lOURNALISM. 

cancer and other diseases. These parti-coloured nostrums were 
taken up strongly by a leading English journalist, and by various 
members of the nobility. For a time it almost looked as if So- 
ciety were to be divided into two classes, those who believed and 
those who did not believe in the claims of the Italian nobleman. 
At length the bubble was happily pricked by the publication of an 
official analysis, which showed that the phials, regardless of their 
colour, were one and all filled with water, pure and simple. Both 
drink curer and cancer curer, it may be noted, agreed in their 
high price, in their absolute disregard for the ways of ordinary 
morality, in their trust in the credulity of mankind, and, above all, 
in their single-hearted confidence in the virtue of advertisement. 

In that last-mentioned point lies more or less the pith of the 
whole matter. Modern quacks and modem quackery, with their 
train of appalling evil, could not exist without the support of 
newspaper advertising. The money spent yearly in obtaining pub- 
licity for proprietary medicines and worthless methods of treat- 
ment is simply enormous, and until the lay press will consent to 
relinquish that source of income, it seems well-nigh hopeless to 
attempt reform in other directions. This aspect of the question 
has been recognized in America, and not long ago a note in the 
Journal of the American Medical Association announced that the 
St. Paul Pioneer Press had decided to sweep its office clear'of 
offensive advertisements. At the same time, the proprietors 
appeal to the public and to medical men to support them in their 
attempt to publish a clean newspaper. It is to be hoped that the 
profession in America will do all they can to help forward so 
laudable an enterprise. Were the medical men of any civilized 
country to take up persistently the cause of the lay newspaper 
that refused quack advertisements, the fame and fortune of many 
a journal could speedily be made or marred. Our influence as a 
profession is exercised upon every class of society, and it is not 
unlikely that if medical men insisted upon the expurgation of 
objectionable advertisements from the public press, that the pro- 
prietors and editors thereof would sooner or later find themselves 
compelled to fall into line with their views. 

There is another weapon of attack against the quack adver- 
tisement evil. If the selling of secret remedies on the strength of 
claims that cannot be established constitute the offence of obtain- 
ing money under false pretences, then th& newspaper which pub- 



)vGoo<^lc 



DAVID WALSH, M. D. 33 

lishes the false statements must surely be guilty of joining in a 
conspiracy to defraud, and be thereby equally liable to public 
■ prosecution. 

In the United Kingdom there is a strange lack of official 
machinery for the defence of the community against quacks and 
quackery. It is not the business of the General Medical Council ; 
it is not the business of the qualifying corporations (except in 
the limited instance of the London Apothecaries' Company) ; it is 
not the business of the police; and it is apparently only in extreme 
and rare cases the business of the Public Prosecutor. 

The evil has existed since the dawn of accurate and sys- 
tematic medical knowledge. Fresh parasites appear for every 
fresh branch thrown out from the parent stem of science. Your 
up-to-date quack is a shrewd fellow, ever on the look-out for a 
smart commercial application of the latest medical advances, be 
they radium, sinusoidal currents, or what not. , As a rule, how- 
ever, he trusts to some simple drug, which may be powerful, mild, 
or inert — it matters not to him which — but he gives it a fancy 
title and claims to cure therewith sciatica, epilepsy, locomotor 
ataxia, cancer, and any or every other disease, curable or incura- 
ble, that can attack mankind. At times he resorts to methods of 
such glaring absurdity that one would think they would not be 
able to secure a single customer. Yet such devices as metal rings 
for the cure of rheumatism, and socks for drawing the same dis- 
ease out through the feet, are advertised year after year at a cost 
that could be defrayed only by a large and flourishing business 
connection. 

Pretenders of this class spend large sums in advertising, 
but it is not easy to understand how any hortourable man, as 
editor, can continue to circulate these misleading statements when 
once their real nature had been pointed out to him. 

Our ancestors gave short shrift to some of the charlatans, 
for in the time of King Henry VIII. the President of the Royal 
College of Physicians of London was empowered by law to prose- 
cute all persons in the metropohs who pretended to cure diseases 
without the proper qualification. That useful provision was sus- 
pended by the introduction of the Medical Acts of 1858, and, 
unfortunately, no efficient prosecutor was therein substituted. 
Our mediseal forbears recognized, even at that comparatively 
early period of medical knowledge, the necessity of excluding 



)vGoo'^lc 



34 ON CERTAIN ASPECTS OF MEDICAL JOURNALISM. 

quacks, and the revival of so excellent a principle appears to be 
vital to the present protection of tiie publk against the bogus 
practitioners and the vendors of worthless, dangerous and fraudu- 
lent nostrums who prey upon them by night and by day. 

One reason why the quacks have hitherto escaped punish- 
ment as a" whole is undoubtedly due to a peculiar sort of sym- 
pathy which exists in minds of a certain order towards bone- 
setters, herbalists, and other irregular practitioners. That feel- 
ing, however, has not saved the quack dentist from the clutches 
of the law. So stringently have the Dentists' Acts been admin- 
istered of late in the United Kingdom that for an unqualified 
person even to advertise sets of artificial teeth or painless extrac- 
tions is now a punishable offence, inasmuch as it is held to imply 
legal qualifications. One magistrate said in so many words he 
thought it admissible for an unqualified man to exhibit a case of 
teeth and to put up his name, but nothing more. He fined an 
unqualified dentist £20 and 5 guineas costs for affixing a notice 
outside his place of business to the effect that he "was not regis- 
tered under the Dental Act of 1878," on the ground that he thereby 
implied qualification elsewhere. On the whole, there can be little 
doubt that the day of the quack dentist is drawing to a close so 
far as the United Kingdom is concerned. That hai»py result is 
chiefly due to the campaign instituted by medical and dental jour- 
nals, a fact that is encouraging in the campaign against the in- 
finitely more nefarious and more deadly practices of the quack 
and the quack medicine proprietor. 

Through all the tragedy of this unhallowed traffic with the 
health and the lives of mankind, the medical journals have main- 
tained a firm attifude of condemnation. Who can doubt that one 
day the collective common sense of mankind will confirm their 
view, and will drive out the unqualified medical pretender from 
their midst, just as in our own country they have practically 
driven out unqualified lawyers, dentists and veterinary surgeons? 
As a simple question of political economy, the sweeping away of 
quackery by the saving in the life and health of citizens, not to 
mention the diversion of money from unproductive into produc- 
tive channels, must infallibly add to and conserve the national 
wealth in a way that would speedily recompense the necessary 
disturbance of vested private interests. 



jvGoo'^lc 



DAVID WALSH, M. D. 35 

"DE QUIBUSDEM ALUS." 

So much has been said about the pirates of medicine that 
little space is left for others that are the common-places of medi- 
cal journalism. Amongst such burning topics may be mentioned 
the decline of the birth-rate, infantile mortality, the campaign 

, against tuberculosis, infant teething, one-portal qualification, faith- 
healing, anti -vaccination, anti-vivisection, medical inspection of 
school children, and the notification of measles. Then there is 
the scientific side of the work, always an important matter. 
As every medical editor knows, many medical men who are highly 
skilled observers fail when it comes to the question of literary 
expression. Some authors resent the slightest alteration of their 
text, while others gratefully adopt any suggestions as to form, 
and it is sometimes hard to say which of the two is the more 
embarrassing from the editorial point of view. In one particular 
the editor requires to exercise the greatest care and prudence, 
namely, in the rejection of scientific communications. The medi- 
cal world of to-day is apt to reject, more or less contemptuously, 
that which is new and heterodox, as it was when Harvey was 
given the cold shoulder for his views about the circulation of the 
blood. In some medical journals it is the custom to keep a sort of 
scientific censor, whose duty it is to determine whether any given 
article is to be accepted or otherwise. Although there is some- 
thing to be. said in favour of this plan, it nevertheless seems unde- 
sirable to run the risk of limiting the progress of medicine by the 
introduction of personal factors. Censorship of the kind should 
be applied sparingly. Of all things, scientific progress is the one 
that depends most upon vigorous breadth and freedom of mind. 
Science requires free trade in intellectual wares, and history has 
shown us again and again that discoveries of the utmost value 
have come from the least likely quarters. 

A few words may now be said about the medical editor. 
One need hardly remark that it requires a man of peculiar gifts 
to fill that position successfully. It by no means follows that 
because a medical man has achieved a distinguished scientific 
and professional career he will necessarily make a good and 

-capable editor. As a rule there can be little doubt that he should 
be engaged in some branch of active professional practice, as 
otherwise he is hkely to lose touch with the complex world with 
which he has to deal. He should be well grounded in general 



zccb/GoOt^lc 



36 ON CERTAIN ASPECTS OP MEDICAL JOURNALISM. 

principles, in order that he may view fresh advances in their 
proper perspective. Before he has long occupied the editorial 
chair, it will become clear to him that the large proportion of his 
professional brethren think that Nature has endowed them to a 
pre-eminent degree with the gifts and faculties required for dis- 
charging the duties of his position. The editor must be versed 
in the editorial side of his work, and be able to select suitable 
subjects for discussion and comment ; he must keep a keen eye on 
reports, reviews, medical news, correspondence, and a number 
of other matters of current interest to his readers. Then it gties 
without saying that he must not disregard the business interests 
of his journal, or he will come into collision with the publishing 
side of his management. 

One of the chief risks ahead of the medical editor is the 
highly technical nature of his proof sheets. To bring a medical 
journal to anything like perfection in this respect is to achieve no 
mean thing. One might till pages with recollections of the havoc 
wrought by printers' errors ; but it will suffice to give one in 
which a compositor made the editor say that a certain distin- 
guished man had treated a subject in his usual "nonchalant" way, 
whereas the real epithet was "trenchant." 

A passing word may be given to the poet who plies the 
editor with doggerel upon every conceivable subject, in season 
and out of season. His emotional nature becomes unduly elated 
if his verses are published in small print at the end of the journal, 
and he waxes sarcastic, or even stops his subscription when his 
rhymes are rejected. The varieties of this particular phase of the 
disease cacathes scribcndi may be classified by some authority on 
mental alienations, and it is in that case to be hoped that he may 
be at the .same time successful in providing a cure for what has 
hitherto proved a distressing, and, in most cases, a hopeless 
malady. 

In conclusion, it may be remarked that the interests of medi- 
cal journalism, like those of medical science, are cosmopolitan, 
and America has built up a system of medical journals of which 
the English-speaking world may well be proud. Whatever the 
future may have in store, we may at all events be sure that the • 
medical journals of America, no less than of the United King- 
dom, will worthily uphold the traditions of a great and noble 
profession. 



jvGoo'^lc 



HENRY O. MARCY. M. D. 37 

THE DEVELOPMENT OF MEDICAL JOURNALISM IN 

AMERICA. 

By Henry 0. Marcy, M. D., Boston, Mass. 

LAST year I had the honor of addressing this Association 
upon "The Modern Era of Medical Journalism in 
America." To-day I outline something of its origin and 
development. Journalism, at its best, can only be the ex- 
ponent of medical thought and teaching and arose from a co^ 
operative attempt to disseminate knowledge. 

It is both an obligation and honor for the physician to 
contribute his quota to the common stock of medical knowl- 
edge, from which he has drawn so freely. 

Prior to the Revolution, the medical profession of the 
Colonies depended almost solely upon Europe for its text bocJts . 
and advanced teaching. 

But one medical book by an American author had been 
published. This was entitled "Plain, Precise, Practical, Re- 
marks on the Treatment of Wounds," by John Jones : New 
York, 1775. 

It very naturally is based upon the works of the popular 
teachers of the English school ; Pott and others. Beside this, 
there had been three reprints and a few pamphlets published 
in the Colonies. Fortunate was the physician of this period 
who owned and mastered the works of the famous teachers of 
Europe at this period. Authors never to be forgotten — Boer- 
have. 

Th? Physiology of Halleo, the Anatomy of Couper, Cheseldon, 
Munroe and Winslow — the Surgery of Hiester (the text book 
of Europe for two centuries and still studied with profit.) 
Sharp, Le Dran and Pott, the Midwifery of Smellie, the Works 
of Lydenham, Mead and Cullen. The one public medical library 
was of the Pennsylvania Hospital of two hundred and fifty 
volumes. 

About three hundred and fifty medical practitioners had 
received a then, so-called, liberal education, of which number 
two hundred had received medical degrees. 

The first medical scliool organized in America was estab- 
lished in Philadelphia in 1765 by Drs. John Morgan and Wil- 
liam Shippen and is now known as the Medical Department of 



jvGoo'^lc 



38 MEDICAL JOURNALISM DEVELOPMENT IN AMERICA. 

the University of Pennsylvania. The founders were both grad- 
uates of the Edinburgh School, which they very naturally took 
as a model. 

Under the charter of King's College the second medical 
school in the Colonies was founded in New York in 1767, 
These efforts in medical training had resulted of necessity in 
little fruitage prior to the Revolutionary War and were closed 
during the prolonged contest. 

Only one medical society had been organized, that in New 
Jersey. No journal had been published. 

In the briefest possible survey, this is the picture of the 
medical profession and its teachings upon the establishment of 
our independence as a nation. 

Even war has its attendant blessings. Prior to this period, 
the sparsely settled, widely separated Colonies had little in com- 
mon of interest or knowledge. By. a dominating cause, they 
were centralized and the leaders came to know each other as 
only soldiers can. 

As in the war of the Rebellion, American surgeons received 
a training which resulted in acknowledged w'orld-wide leadership, 
so, during the long years of co-ordinated service the surgeons 
of the Revolution became a self-centered body of well-trained 
men, the pioneers in the medical development of the nineteenth 
century of which we are so justly proud. 

Of the armentarium of the physician in this early period, 
in America little need be said — opium, calomel, ipecac and anti- 
mony were regarded as the four staples to which the lancet by 
frequent and exhaustive bleedings was considered an indispensa- 
ble aid. The best thinkers recognized their narrow limits in the 
care for disease, fighting unknown enemies by uncertain and 
dangerous weapons. 

I have in my possession a thick volume, well bound, cjn.sist- 
ing chiefly of blank leaves. The author energetically commenced 
his story, but leaves, for the most part, the finishing to the 
fancy of his readers. 

Such the uncertain state of medical therapeutics at the 
commencement of the last century! Boerhave, who died in 
Leyden in 1738, left as a legacy to his profession, an elegant vol- 
ume, the title page of which declared that it contained all the 
secrets of medicine. Every page of the v«lume was blank except 



JyGOO'^IC 



HENRY O. MARCY, M. D. 39 

one On this was written, 'Keep the head cool, the feet wann 
and the bowels open." 

Linneeus, who died in 1778, stimulated the medical pro- 
fession in new lines of research. 

The discussion waxed warm between the so-called pharma- 
cists and chemists; one claiming that God had given, in the 
vegetable kingdom, a sovereign remedy for all ill, if we could 
only find it ; the other that it was to be found in the mineral 
world. 

Dr. Fothergill, of London, author of the Institutes of Medi- 
cine, a wealthy practitioner, under the new teachings of Lin- 
naeus, determined upon a study of the botany of the new world. 
Dr. John Bartram, of Philadelphia, a surgeon in the Revolution- 
ary War, one time botanist to the King of Great Britain, fellow 
of the Royal Society and one of the few scientists of America. 
His then residence, now held in grateful remembrance in Phila- 
delphia as the Bartram Gardens, had his son William carefully 
educated in England. Dr. Frolhergill commissioned him for the 
study of the plant life in the South ; chiefly in the Appalachian 
regions and in Florida. He commenced his studies in April, 1773 ; 
spent much of 1774 in Florida, returning to Philadelphia in Jan- 
uary, 1778. The indirect fruitage of these investigations is em- 
bodied in one of the most interesting books of the period entitled 
"Travels Through North and South Carolina, Georgia and Flor- 
ida." 

This rare work is of present interest to the general reader, 
doubly so to nie, because of my own studies for some years in 
the Appalachians. 

The first literary contributions of American physicians, at the 
close of the Revolution, are found in the memoirs of the Ameri- 
can Academy of Arts and Sciences, Boston, 1788, and in the 
Transactions of the American Philosophical Society of Phila- 
delphia in 1788. In the same year there was published in New 
Haven, Conn., the first original medical book of 86 pages Dys- 
entery among the soldiers of the late war was the subject of 
special interest, though in large measure due to overcrowding 
and foul air. The larger number of medical papers to the end 
of the century related to yellow fever, for a time epidemic 
along Ihe entire .Atlantic coast. Its frightful ravages in Phila- 



)vGoo'^lc 



40 MEDICAL JOVRSAUSM DEVELOPMENT IN AMERICA. 

ciclphia have been recently vividly portrayed by Dr. Weir Mitchell 
in his novel entitled "The Red City." 

Dr. Benj. Rush's writings upon the subject were consid- 
ered classical. As a pioneer in American Medicine, he is worthy 
C.'.c place assigned to him in ihe history of our profession. 

In a very valuable contribution to the medical history of 
America, by Dr. John S. Billings, U. S. A., entitled "Literature 
and Institutions" published by H. C. Lea in 1876: "A Century 
of American" and from which much of the data used in this 
article has been taken, I find the following: "The first medical 
journal printed in this country was a selection and translation 
from the "Journal de Medicine Militaire " issued in Paris from 
1782 to 1788. This translation was published in New York 
about 1790. forming a volume of one hundred and twenty pages, 
8vo, which is quite rare. 

The original journal, from which this is made up, is one 
that is valuable to the army surgeon and the reprint is here re- 
ferred to as being the first medical journal printed in the United 
States and the fact of its existence is probably known to very 
few. Such a publication is a reprint, published in book form, 
and can hardly be called a journal. 

"The Medical Repository" edited by Drs. Mitchell, Miller 
and Smith was established quarterly in 1797 and was continued 
until 1824. Dr. Samuel L. Mitchell, 1764-1831, was much in- 
terested in the natural sciences and literature, rather than the 
practice of medicine. He was a representative to Congress and 
United States Senator from 1804 to i8oq. The Medical Re- 
pository was merged in the "New York Medical and Physical 
Journal" and Xew York City has been continuously represented 
by medical journahsm since: to date 112 years. The most im- 
portant of the early journals published in New York was the 
"American Medical and Philosophical Re.tjister" established in 
1810 ; "The New York Journal of Medicine and Surgery" 1839; 
"The New York Journal of Medicine" edited for a time by our 
esteemed and much loved Dr. Stephen Smith. The New York 
Medical Journal, 1865, edited successively by Drs, Hammond, 
Dunster and Hunter, all personally known and loved by us and 
for many years this journal found a prominent place upon my 
table and to its pages I was a contributor. 

The New England Journal of Medicine and Surgery, pub- 



)vGoO'^lc 



HENRY O. MARCY, M. D. 41 

lished quarterly, was first issued in 1812, was joined to the In- 
telligencer Weekly in 1823 and was finally merged in the Boston 
Medical and Surgical Journal in 1828. which continues under 
this name to now. 

'"The Philadelphia Journal of Medical Science" was first 
published in 1820. 

The second medical journal in this country was the "Phila- 
delphia Medical Museum," edited by Dr. Coxe. It was established 
in 1804 and was discontinued in 181 1, The same year Dr. B. S- 
Barton established the "Philadelphia Medical and Physical 
Journal," continued irregularly until 1809. 

Dr. John R. Coxe, 1773-1864, was noted as a lover of an- 
cient hterature, a student of Dr. Rush. Later in Edinburgh and 
Paris, was a professor of Materia Medica and pharmacy and was 
distinguished as the first medical editor of Philadelphia. 

Dr. Benj. S. Barton, of Philadelphia, gave much of his 
time to medical editorship in Philadelphia at this early period. 

Dr. Robley Dunglion : born in England, educated in Edin- 
burgh, Paris and London, was one o the editors of the "London 
Medical Repository" in 1823-24; at the invitation of Thomas 
Jeflferson, he accepted a professorship in the University of Vir- 
ginia. In 1836 he became a professor in Philadelphia where 
he died in 1869. Of his many publications, he is best remem- 
bered by his medical dictionary, the first edition of which was 
published in Boston in 1833. Later editions were edited by his 
son, Richard, a man of refinement and erudition, first editor 
and co-founder of the American Academy of Medicine, a warm 
personal friend for many years until his death. 

Dr. Daniel Drake, of Cincinnati, was one of the most dis- 
tinguished medical men of his period. His work upon the mal- 
arial diseases of the "Interior Valley of North America" is 
the result of a long life of extensive personal observations and 
careful study; a work of permanent value. 

He founded the "Western Journal of the Medical and Phy- 
sical Sciences." To it he gave much of his best efforts. He died 
in 1852. 

It is to be regretted that his contributions to medical science 
and literature are not better known to the present day student. 

Dr. L. M. Lawson, 1812-1864, of Kentucky and Ohio, is a 
man to be remembered. He was an excellent teacher and writer. 



jvGoo'^lc 



42 MEDICAL JOURNALISM DEVELOPMENT IN AMERICA. 

He founded and for a. long time conducted the "Western Lancet," 
in which many of his lectures were published. 

Dr. Horace Green, 1802-1866, was born in Vermont. He 
was a graduate of Castleton Medical College in 1824. He was 
professor of Theory and Practice of Medicine in the New 
York Medical College and in connection with this school, he, 
with his colleagues, established the "American Medical Monthly," 
He was the first to devote himself in practice to a specialty, "Dis- 
eases of the Chest," 

The three Beck brothers were justly celebrated. Said a 
writer of the period. "There are probably not to be found in 
the annals of medicine so large and valuable contributions to its 
literature as were made by the Beck family of New York. J. G. 
Beck, 1794-1851, in 1822 assisted in founding the "New York 
Medical and Physical Journal," with which he was connected 
for the next seven years and in which he published numerous 
articles." 

Philadelphia has been a centre of medical teaching and pub- 
lication from the first. Beside the journals already mentioned, 
a quarterly, the iiAmerican Medical Recorder." 1818-29. The 
"North American Medical and Surgical Journal" 1826-31. "The 
Medical Examiiier," 1838-56. 

The "American Journal of Medical Sciences" has held a 
first place in our literature. The new series began in 1825, was 
edited by Drs. Chapman, Dewes and Godman. 

In 1827, Dr. Isaac Hayes rechristened the journal under pres- 
ent name. He devoted much of a long life to its supervision and 
was the most distinguished, as I think, the first American phy- 
sician to specialise as a medical editor. Dr. Chapman is said to 
.have undertaken the editorship, stimulated by the sneering crit- 
icism of Sydney Smith, "Who reads an American book." 

The Baltimore Medical and Physical Recorder was the 
third medical journal published in America by Dr. Tobias Wat- 
kins, 1808. 

This was discontinued in about a year. Dr. Austin Flint, 
who has won immortality in medicine and was loved by many still 
active, was the first editor of the "Buffalo Medical Journal," estab- 
lished in 1845. In 1822 the first medical journal west of the 
Alleghenies was established, entitled the "Western Quarterly Re- 
porter of Medical, Sudgical and Natural Science," edited by Dr. 



jvGoO'^lc 



HENRy 0. MARCY, M. D. 43. 

John D. Goodman, of Cincinnati, 1822-23, After a brief struggle 
for existence it ceased to live early in its second year. 

The infantile mortality of the Ohio journals at this period 
was very great. 

The "St, Louis Medical and Surgical Journal" was founded 
in 1843. 

In the South the first medical periodical was the "Journal 
de la Societe Medicale de la Nouvelle Orleans," a quarterly pub- 
hshed in 1831. 

The Charleston Medical Journal and Review, 1846-60. 1873. 
In Tennessee, "The Nashville Journal of Medicine and Surgery," 
1851-61. Suspended during the war, republished in 1866. The 
"Virginia Medical and Surgical Journal" was edited hy Dr. Geo. 
A, Otis and others, 1853-61. Dr. Otis moved to Springfield, 
Mass., where he remained until he entered the U. S. Service. 
At the close of the war he entered upon the monumental labor 
of his life in establishing the U. S. Army Museum and publish- 
ing the medical and surgical history of the Civil War. I spent 
nearly a year in his service. He seemed never so happy as when 
preparing a rare specimen. Small of stature, quick of action, 
soft of voice, fond of music, he, once seen, was to be remem- 
bered. His contributions are, perhaps, the most noteworthy of 
any American author, 

"The Confederate States Medical and Surgrcal Journal, 
1864-65, was of limited circulation and recorded valuable facts 
relative to service in the Southern armies. 

The oldest journal of the Pacific coast is the "Pacific Medical 
and Surgical Journal" first issued in 1858. 

I have sketched all too briefly the rise and development of 
medical journalism in America. In playing the part of the his- 
torian. I refrain from being the critic. I had quite forgotten an 
article which I published in the Journal of the American Medical 
Association, July 21, 1883; a paper which I read before this 
Association of Medical Editors, June 5, 1883, upon "Journalism 
Devoted to the Promotion and Concentration of Medical and Sur- 
gical Science" I close this paper by reading from it a few 
brief extracts. 

The special characteristics of the literature of the present 
day are largely due to journals and transactions, and this is 
particularly true in medicine. Our periodicals contain the most 



jvGoo'^lc 



44 MEDICAL JOURNALISM DEVELOPMENT IN AMERICA. 

recent observations, the most original matter, and are the truest 
representations of the living thought of the day, and of the 
tasks and wants of the great mass of the medical profession, a 
large part of whom, in fact, read very little else. They form 
about one-half of the current medical literature, and in the year 
1879 amounted to 655 volumes, of which the United States pro- 
duced 156; Germany 129; France 122; Great Britain, 54; Itajy 
65 ; and Spain 24. This is exclusive of journals of pharmacy, 
dentistry, etc., and of ournals devoted to medical sects and isms. 
It will be seen that at present more to this class of literature 
appears in the English language than in any other, and that the 
number of journal contributions is greatest in the United States, 
A marked increase has occurred in the literature of hygiene 
during the last two years, and this especially in England, France) 
Germany and the United States. The literature of disease of 
the nervous system, of opthalmology, dermatology and gynaecol- 
t>gy is also increasing more rapidly than that of the more general 
branches. 

The increase in both the amount and value of the literature 
of the several specialties in medicine is readily seen by a com- 
parison of recent catalogue and bibliographies with those of 
twenty or thirty years ago, and this increase still continues at a 
greater rate than prevails in the more general branches. There 
are great differences of opinion as to the relative value of this 
increase and as to the future effect upon the profession, but 
there can be no doubt as to the fact. 

There must be specialties and specialists in medicine and the 
results will be both good and evil ; but the evils fall largely 
upon those specialists wlio have an insufficient general education ; 
who attempts to construct the pyramid of their knowledge with 
the small end as a foundation. It has been said by Dr. Hodgen 
that "In medicine a specialist should be a skilled physician and 
something more, but that he is often something else — and some- 
thing less. * * * 

Thus we have many workers in many fields of labor. Some- 
thing of the astonishing magnitude of the resuh accomplished is 
apparent as we turn the closely printed pages of the Index Medi- 
cus in its monthly visitations to our tables. This latest outcome 
of specialistic journalism is the greatest marvel of them all. 

He who has. or who thinks he has, a new inspiration will 



)vGoo'^lc 



HENRY O. MARCY. M. D. 45 

do well to examine carefully its pages and see if his own thoughts 
have not been better expressed by another, and thus save himself 
the mortification and chagrin of being shown up by some merci- 
less reviewer as having purloined the original observations of 
Dr. Smith, or mutilated the wiser teachings of Mr, Jones, He 
who seeks to know further than that which has been written 
will do well to consult the long row of quarto volumes; the 
catalogue of the library of the Surgeon-General's office. 

From it, although not a complete index of all that has been 
written, we gather some idea of the accumulated lore of the 
world's work in our especial field of labor. 

We all possess diversity of gifts, but should be actuated 
and guided by one spirit. The cavalry shall not say to the 
infantry "you are too slow for our purposes',' the infantrj' 
shall not say to the artillery "you are too heavy and cumbersome 
in your outfit," but all with one accord as members of the grand 
army strive to accomplish the work set before it. 

With this end attained, under the clear light of scientific 
truth, the isms which smack of ignorance wilt cease to exist, new 
fields of labor, more attractive because nearer to the great source 
of truth, will open and there will yet arise a more noble emula- 
tion for the still greater advancement of a united and harmonious 
profession. 

REMARKS ON DR. MARCY'S PAPER. 
President Crothers — While we cannot discuss a paper of this sort, 
I am sure it is much appreciated for the resume of the past which it gives 

Win. Porter — It seems to me we ought not to pass this paper by with 
the mere word of commendation which has been given. I have listened to 
it as I have not listened to any other. I find myself indebted to the author. 
The records that he has gone through, the trouble that he has undertaken 
for us in presenting an epitome makes it exceedingly valuable to us, going 
as it does away back and linking that' dim past with the present day in 
which we are living without hardly stopping to realize the steps by which 
we have come. It seemj to me, gentlemen of the Association, that we can- 
not listen to a paper of this kind without receiving new inspiration. It is 
not easy lo put ourselves in the position of the other man, yet if we look 
back for inspiration to the work of the pasi, seeing how it has lived after 
those who did it, we will get inspiration for our work. 

Every time I speak to an audience like this I feel that the moments 
are sacred. In just that way I feel that editors should feel that every line 
they write is sacred. He is going to be quoted, if he says anything 



)vGoo'^lc 



46 MEDICAL BOOK REVIEWS. 

worth while, and he should be responsible for everything he says. This 
feeling of inspiration is what I get when I listen to Dr. Marcy's paper, not 
something to bang on the wall, but a sacred inspiration that pays me for 
taking the time to come here. 



MEDICAL BOOK REVIEWS. 

By James P. Warbasse, M. D. 

American Journal of Surgery. 

MEDICAL book reviews involve three different factors : 
the publishers of the book, the journal publishing the 
review, and the reviewer. The object of sending- out 
books for review is a commercial one, with the aim of 
calling the attention of prospective buyers to the publication and 
with the hope of securing favorable or praiseful criticism. The' 
object of the journal in publishing reviews is a literary cultural 
one, aiming to give its readers the benefit of information con- 
cerning new books and therebj' increasing the value of the 
journal. Secondarily, is the desire on the part of the journal to 
secure copies of new publications. The object of the reviewer is 
found in his interest in the journal and in contributing some- 
thing of value to its pages, his interest in the subject of the 
book prompting him to take this means of keeping in touch with 
the most recent publications, his desire to add books to his own 
library, or some other pecuniary or professional interest. In a 
general way, these are the interests and objects involved in 
medical book reviews. 

The methods at present employed consist in publishers send- 
ing copies of their publications, bound in cloth, to such journals 
as are read by those in whom they see prospective purchasers. 
Most publishers send with the volume a letter to the editor and 
also a review of the book. This review has been written in the 
interest of the publication, and may, because of its commercial 
character, be designated as "machine made." The publishers re- 
quest an early review, and beg that a copy of the journal contain- 
ing the review be sent them. The receipt of the book should be 
acknowledged by the editor and the requests of the publishers 
complied with. The book is placed in the hands of the reviewer ; 
or the review is written by the editor himself. Most of the med- 
ical journals publish book reviews. Practically all of them ac- 






„Gooi^lc 



JAMES P. WARBASSE, M. D. 47 

acknowledge or publish in some form announcements of the new 
books received. 

These methods are of value to all of the three factors con- 
cerned ; and medical book reviewing in our medical journals stands 
as a constant testimony to the value of co-operation between com- 
merce and the profession of medicine/ whereby each is benefited. 
While we acknowledge the value of this co-operative interest, 
some further profit may acrue, if we enquire whether any of the 
methods above referred to may not be modified or turned to bet- 
ter advantage to the medical profession and possibly to the publish- 
ers also. It is my own belief that our system of book reviewing 
might be improved ; although it must be said to the credit of many 
of our medical journals that their reviews are honest, fair and 
admirable criticisms. 

In the first place let us consider the interest of the whole 
profession to which the book review is addressed. We see at 
once that the "machine made'' review is not fair to the reader 
because of its commercial bias. It may be said of many of these 
reviews emanating from the publishers, that they are good — well- 
written, calling attention to salient points; and if the book is 
really a good book, they are just criticisms. But nothing, not 
even this, can excuse the publication by a medical journal of these 
reviews. If they are just and good, it is because of the fortuitous 
circumstances that the book is a good book. The animus inspir- 
ing them makes these reviews utterly worthless ; and it is an in- 
sult to the readers of a journal to publish them. Motives are 
matters which should receive consideration in medical journalism 
just as well as in courts of law. I am sure that publishers have 
a peculiar smile of complacency, mingled with guilt, when they 
slip one of these machine products into an envelope and send it 
to receive the salutation of benign credulity of a medical jour- 
nalist. If publishers desire criticism and a review of their books, 
let journalists insist that the publishers need not do the work for 
them. If medical journals are to give the profession a decision 
upon the merits of a book, let the decision be handed down from 
the bench and not be written by one of the interested parties. 

One of the weaknesses of publishers is that they do not take 
sufficient advantage of honest criticisms of their books. It too 
often happens that errors are pointed out by reviewers, and sub- 
sequent editions continue to perpetuate them. This may be due 



)vGoo'^lc 



48 MEDICAL BOOK REVIEWS. 

to the failure of the journal to send a copy of the review to the 
publishers, and commonly it is the resuh of failure to revise, for 
economic reasons, a work with known imperfections. 

Thus far I have only implied that medical journals publish 
"machine made" reviews. I now desire to make the assertion 
that many of them do publish them. Sometimes this is done in 
part, sometimes in tato. Sometimes they are revised so as not 
to be typographic reproductions, but still reproductions. The 
first sentence is omitted ; commas become periods ; "good" be- 
comes "excellent ;" and, saddest of all, sometimes somebody sub- 
scribes them with his initials. But few publishing houses refrain 
from insulting the medical profession with "machine made" re- 
views. If editors would return them with their polite form of de- 
clination, regretting their inability to use them, these ready made 
reviews would become obsolete. Publishers have been compelled 
to resort to these things in self-defense. They have learned that 
unless they give the reviewer some help, there is a strong prob- 
ability that their book would not be reviewed. It is the sop to 
the lazy man. Most publishers prefer that an honest review be 
made, even though it is not altogether favorable, than that the 
conventional generalities be published. 

Another matter to which I desire to call attention is that, 
while every medical journal is a center to which books for review 
and exchanges gravitate, a journal office rarely makes these two 
great library materials available to the general profession in 
whose community it exists. Most books thus received are given 
to the men who write the reviews. They place them in their 
libraries or dispose of them in some other more or less advan- 
tageous way. But in general these books are disseminated. The 
same with the journals; the editor retains some, the rest are 
scattered and eventually reach the junk man. The medical journal 
can perform an important service by becoming either the nucleus 
or the feeder of a medical library. Suppose the case of a journal 
in a community having no library. Let the profession or the 
county society organize one with the co-operation of the journal; 
by subscribing for a few journals not received in exchange ; by 
giving some special attention to the book review department of the 
journal; and by urging members to donate and bequeath their 
old books, a combination of forces is set at work which will result 
in the making of a library, and in improving the value to the com- 



jvGoo'^lc 



JAMES P. IVARBASSE, M. D. 49 

munity of the journal. The best feeder for a medical library is a 
medical journal. It is as good as an endowment fund. 

Members of the library organization society are willing, for 
the benefit of the whole profession and of the library, to write the 
book reviews and then place the books in the library, not accepting 
them as the price of their reviews. I do not speak of this as a 
theory, but as a plan that has been well tried and found successful. 

Publishers, it is contended, prefer to have review copies scat- 
tered and lost. It is argued that if the books are always to be 
found by the profession where they are available in some central 
place, the individual members do not find it necessary to buy the 
book, but consult it at the library. This is a theory ; against it 
may be placed the fact that the more general interest that can be 
aroused in a book the more copies will be sold. Moreover, the 
library plan is in the interest of the whole profession, for whom 
we are naturally more concerned than for the interests of the 
publishers ; for, incidentally, I am prompted to say that, if there 
is any one class of men whose talents are commercialized to feed 
fat the pockets of publishers, it is those members of the medical 
profession who are the authors of medical books. 

The first objection to the prevalent system, then, is that the 
steady stream of new books flowing into the journal office is not 
conducted to a reservoir, but is dissipated into many channels and 
disappears. The second objection is that the character of a large 
proportion of the reviews is such that the prospective buyer is 
deceived as to the merits of the book. Were I to mention the 
most glaring defect of our medical book reviews, I should say 
that it is that they deal too much in generalities and not suffi- 
ciently in specific statements of fact. Most reviews generalize 
upon the merits of the book. Here are some generalizations: 
"This volume should have a place upon the shelves of every up-to- 
date physician engaged in the general practice of medicine." This 
is hackneyed and too general. "As a thoroughly scientific and 
up-to-date work, the volume under consideration must be re- 
garded." Again stereotyped and general. "This book has the 
stamp of literary and scientific excellence from the preface to the 
finish." Here much thanks are due to the author for omitting 
the title page and index from his eulogium. "This book will be 
relished by all who have a taste for the good things in literature," 
might imply ihat the reviewer meant to recommend that we .should 



)vGoo'^lc 



oy MEDICAL BOOK REVIEWS. 

eat it. Indeed, here is something from a recent State journal 
that conclusively shows this disposition on the part of reviewers 
to become so hypnotized with affection for the lender volume 
receiving- their caresses that they are prompted to employ this 
extreme expression of affection: "The proof of the pudding is in 
the eating, and this book, like the pudding, must be eaten to be 
thoroughly appreciated." One of the most verbose publications 
that has recently appeared has been described as wrilten in "ad- 
mirable and terse literary style." "No up-to-date practitioner can 
afford to get along without this excellent work," was said several 
years ago of a book without which a large number of up-to-date 
practitioners are still getting along pretty well. 

How much better than these generalities are simple state- 
ments of specific facts. To publish the table of contents, to give 
a few excerpts from the book, or to say that it has or has not an 
adequate index would be better. We beg for some fact about a 
book. It is just the plain truth, not rhetoric, that the reader wants. 
If a reviewer has not time, or if the journal can not give the space 
to a review, something original about the book can be said, if it is 
nothing more than the quotation of a few sentences from the 
text. If time and space permit, this method may be amplified. 
Some of the best short reviews are made up of quotations, the 
reviewer selecting just those passages which are peculiar to the 
book and give an idea of its character. But still better is it to 
add to the statements of what the book contains and what it says 
the opinion of the reviewer upon these things. Comparative 
reviews are always of value, setting the merits of a book over 
against other books on the same subject, and criticising it in the 
light of the most recent knowledge. No reviewer need hesitate 
to criticise an author for devotion to traditions. Books which 
simply pass along the traditional wisdom and errors of past gen- 
erations and add httle need not be spared criticism. The author 
who writes himself into his book should have the approval at 
least, if not the praise, of reviewers, 

A review that gives an idea of the character of a book by 
telling what it contains and what it says upon some of the more 
inijjortant questions dealt with need not be signed ; but a review 
in which the opinion of the reviewer is expressed should reveal 
the authorship of the review. The day of anonymity has passed ; 
this is the age of honesty and frankness. 



)vGoo'^lc 



/AMES P. IVARBASSE, M. D. ai 

The modification of the tenor of a review according to 
whether the publisher does or does not advertise with the journal 
might seem incredible were it not for the fact that it does exist, 
and has influenced reviews in some of our most important medical 
journals. 

Among the measures for securing- the best resuhs to the 
three factors concerned in book reviews and to the medical pro- 
fession as a whole are the discontinuance of the machine made 
review by the publishers, the preservation of new books by the 
journals for common use, and the simple and honest statement 
of facts by the reviewers. The first will be accomplished when 
the reviewers and journals cease to make use of the commercial 
review ; the second can be accomplished by a spirit of co-operation 
between the journal and the local profession ; and the third by a 
simple request from the editor as to the character of the review 
desired. So important can be the medical journal as a contributor 
to the medical library, and so highly should the services of the 
reviewer be esteemed, that to journals which contribute their 
books to such libraries publishers should send two copies of the 
books which they desire reviewed, one for the reviewer and the 
other for the library. If these two copies are bound simply in 
paper, as is done in Germany, the expense to the publishers is but 
little increased; and the journals which publish real reviews of 
books could expect to receive this courtesy. When all of the jour- 
nals in this country desire this, make their reviews worthy of it, 
and so request from the publishers of medical books, the pub- 
lishers will concede'their request. 

Journals which can not give space to review all books sent 
them should at least publish the title, author's name and the name 
'of the publishers; or in Heu of a review, an idea of the book can 
be given by publishing the title page; and it always adds to the 
value of a book-notice to publish the price of the book. 

The honest reviewing' of medical books is too important an 
obligation imposed upon medical journalism to be slighted. It is 
to it that the book buyer should look for information concerning 
the book rather than to the opinions of the book agent or the ad- 
vertisement of the publishers. It is the popular and conventional 
thing to deride the multiplication of books and to cast aspersions 
upon their makers ; whereas, it should be regarded as one of the 
signs of the progress of medicine in this country that we publish 



:„,;.= b/GoOt^lc 



5« MEDICAL BOOK REVIEWS. 

many books. Xon-progressive countries do not issue books. They 
are the evidences of mental activity; and while it is often said 
that but little is published that is new, still every book ccwitributes 
something to clarify or elucidate, to provoke thought or interest, 
or to bring up to date and eliminate the superfluous from some 
branch of medicine. Practically all bodes are good books. I 
know of no book that has been written by a regular physician that 
has not merit. Moreover, the more books that are published, the 
more must enter the hands of the medical profession. Publishers 
do not issue books unless there is a market for them. And one 
of the best signs of progress of medicine in this country is that 
many books are bought. 

Publishers in sending out cc^ies of iheir publications for 
review really do so with the desire to have the book read and re- 
viewed; and it is the duty of medical journalism to give an honest 
opinion upon new books or else none at all. 

The great army of medical men keep in touch with the medi- 
cal progress of the world chiefly through current medical journals 
and the new books. These are the agencies by which the leveling 
of the profession is maintained. The man who has had experi- 
ence and who has made observations which may be of service 
to others transmits the benefits of his work to all the world through 
these channels. It behooves medical journalists to keep these two 
educational powers in harmony and working tc^ether for the 
general good of the profession whose mission is the healing of the 
sick and the preserving of the well. 

DISCUSSION ON DR. WARBASSE'S PAPER. . 

C. H. Hughes — Very briefly I would like to compliment ;his paper 
It gives some extellent advice regarding how to handle books, but we must . 
remember that the publisher gets his recompense from ihe sale of books. 
In Europe they send out paper-bound copies of books for review and 1 
regret to see tliat the custom is beginning to be adopted in this country. 
I consider this an insult to the author of the book review to offer him & 
paper-bound book in cons iii "rat ion of the time he lias 'aken to prepare th| 

I must say that I approve of the custom of publishers in sending out 
short reviews ready-made with the books — at least to the extent of the 
price, authorship, title and subtitles, I am always glad when a publisher 
sends me this information in form so that I do not have to spend time 
looking it up. 



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FIELDING H. GARRISON, M. D. 53 

ON EDITORIAL REVISION OF TITLES OF MEDICAL 
PAPERS. 

By Fielding H. Garrison, M.D., Washington, D. C, 

ASSISTANT EDITOR, "iNDEX MEDICUS." 

DR. JOHN S. BILLINGS, to whom all workers for the 
advancement of medicine are so much indebted, once 
gave the following rules for the composition of a medical 
paper: "i. Have something to say. 2. Say it. 3. Stop 
when you have said it. " 4. Give the paper a proper title." These 
laconic rules are not to be looked upon as a mere ifse dixit, but 
represent the summation of years of close observation on the 
part of an experienced bibliographer. Concerning the fourth 
rule, with which we are specially concerned, Dr. Billings said on 
the same occasion that "every article which is worth printing is 
worth a distinct title, which should be as concise as a telegram 
and be printed in a special type. If the author does not furnish 
such a title, it is the editor's business to make it and he should 
iiot be satisfied with such headings as "Clinical Cases," "Difficult 
Labor," "A Remarkable Tumor," "Case of Wound, with Re- 
marks." This is in some sort the gist and conclusion of the whole 
matter, and at the time that Dr. Billings wrote — the Interna- 
tional Medical Congress of 1881 — there were many medical papers 
to which his criticism was applicable. To-day the extensive im- 
provements in medical education and the methods of medical 
journahsm have -had such effect upon medical literature that 
apart from occasional ambiguity or obscurity, little exception 
could now be taken to the titles of medical papers in general. 
It may be of interest, however, to expand the theme a little fur- 
ther, by way of a theoretical discussion of the subject. 

The real test of the literary skill of the average practitioner 
or surgeon is not so much in the writing of learned disquisitions 
as in giving a correct and clearly stated record of his clinical 
experiences. The well-reported clinical case is the basis of medi- 
cal literature, and, strange as it may sound, is quite as important 
.as certain kinds of laboratory work, and sometimes even more so. 
As Professor Clifford Allbutt puts it; "Much of the work which 
is done in our laboratories and dignified, not improperly perhaps, 
with the title of research, much plotting of curves, much watch- 
ing of levers and thermcmeters, nay, not a little morphological 



jvGoo'^lc 



54 ON EDITORIAL REVISION OF TITLES. 

dissection and cabinet- making, are really little more than clerk'.'^ 
work," for "Bundles and files of facts are not science,"* What 
makes them science is the synthetic or creative imagination which 
finds the general laws lurking behind related facts. The busy 
practitioner seldom reflects that in properly diagnosing an obscure 
or difhcult case, he is applying the same analytic and synthetic 
methods which are at the basis of all the great monuments of 
scientific endeavor. Such are the treatises of Hipporates and 
Galen, Harvey's De motu cordis, Morgani's De sedibus, Syden- 
ham's, Addison's, Bright's, Virchow's descriptions of disease, the 
clinical methpds of Auenbrugger, Laennec and Skoda, the mas- 
terpieces of Darwin, the demonsti-ations of Jenn«r, Pasteur,. - 
Laveran, Koch and Lister, and to come to our own country, the 
work of William Beaumont, of Daniel Drake, of Reginald Fitz 
and of Walter Reed. 

To begin with, assuming a contributor to have sent in an 
acceptable paper, what should be our criterion of a suitable title 
"as concise as a telegram?" The titles held up for censure by 
Dr. Billings do not fulfil this condition because, at best, they are 
only glittering generalities that tell nothing in particular about 
the real content of the papers they represent, very much as if a 
telegram announcing the death of a near relative should say no 
more than "a relative of yours is dead," What we want to know 
in each case is the definite disease, the kind of labor, the site and 
origin of the tumor, the locality of the wound, etc., and data of 
this kind can only be obtained by finding what the Germans' call 
the Schwerpunkt or center of gravity of the subject-matter. In 
printed books of earlier centuries, title pages were, as we know, 
often lengthy and rambling, not to say maundering, and even now 
we see things of this kind, titles which remind us of the tendency 
in old plays to announce the state of affairs at the outset of the 
dramatic action by means of some tedious monologue spouted by 
one of the characters. Fortunately for the modern world, divi- 
sion of labor and the enormous demands made upon our time 
have even had a salutary effect upon play-writing, and, to-day, a 
competent stage-manager demands that in any "well-made play" 
the tiresome monologues should be set aside in favor of crisp 
"lines that create atmosphere" and "lines that indicate character." 
This might well be the ideal for the title of a modem medical 
book or journalistic contribution. It should dramatize the subject 



)vGoo'^lc 



FIELDING H. GARRISON, M. D. 56 

matter of the author's work with a definite eye to "values." aimug 
e^ieciaQy at precision and concision, so as to be, in sbort. a guide 
post to the intelligence or ignorance of the reader. In the mat- 
ter of reporting ordinary clinical cases, all this is very simple, and 
good models can be found almost anywhere, particularly in the 
Latin indices of cases in German hospital reports. These tell us 
exactly what we want to know, the definitive nature of the disease 
{when ascertained), its origin or location and the result of treat- 
ment, even though it be "exitus lethalis " For statistical as well 
as clinical reasons, these details of "visum et repertum" are of 
capital importance. 

In all surgical conditions, as appendicitis, hernia, intestinal 
obstruction, tumors, extra-uterine pregnancy, middle-ear disease, 
etc., the statistician wants to know if there was an c^eration and 
whether it was successful or not. The alienist, the bacteriologist, 
the eye, ear, or nose and throat specialist, the gynecologist, the 
obstetrician, the pediatrist, the orthopedist, the railway surgeon, 
the dentist, will, each and all of them be looking for features in 
medical titles that appear to them as specialists. If the reader 
be an anthropologist, a medical topographer, or a public health 
officer, he may have an eye for the racial equation of the patient 
or the geographical locate of the diseases ; and it is of special 
importance to the military or naval expert to know of pathologi- 
cal conditions in a body of troops or on board ship. The occu- 
pation of the patient, the sources and modes of transmission of a 
disease, the distribution of a disease in space and time, the cor- 
roboration of new methods of diagnostic procedure, the curve of 
new drugs and new operations, are all details that sometimes de- 
mand to be thrown into definite relief in the titles of medical 
papers. In introducing a new drug or anesthetic, it is of moment 
to make the title emphasize untoward effects, if such there be, as 
stoppage of the heart or respiration or death, and certainly no 
new drug ought to be exploited in a medical paper on the basis 
of only two or three cases in the physician's experience. In re- 
porting fatal cases, an important item to be sometimes featured 
is the nature of the ccanplicating circumstances, the mixed infec- 
tion, if any, and more especially, the so-called "terminal infec- 
tion." "It may seem paradoxical," says Osier, "but there is truth, 
in the statement that persons rarely die of the disease with which 
they suffer. Secondary infections, or as we are apt to call them 



)vGoo'^lc 



56 O.V EDITORIAL REriSlOX OF TITLES. 

in hospital work, terminal infections, carry off many of the in- 
' curable cases in the wards." It is evident that many private cases 
are imperfectly reported in this respect. In reporting fatalities 
in private practice, there is delicate matter for the casuist. For 
reasons sutSciently obvious or various, many physicians do not 
report their fatal cases in medical journals, nor is it strictly 
incumbent upon them to do so. Furthermore, a particular treat- 
ment may be rushed into print as "successful" and the patient 
die shortly after the case has been published. The grim irony of 
such cases as these was well emphasized by Dr. Billings in speak- 
ing of the early days of trephining for epilepsy (1861.), If the 
operation "does not prove immediately fatal," he said, "and the 
surgeon reports the case early, say, within the first month, it will, 
in very many cases, come into the lists of cases cured by surgical 
treatment."* 

Leaving simple case-reporting, we come to titles of a more 
general nature, titles of books, monographs, etudes, protocols of 
laboratory data, expert opinions in medical jurisprudence, con- 
troversies, discussions, facetiae and the like. Here no general rule 
can be laid down beyond the simple one mentioned at the outset, 
that in his titles a writer should dramatize his subject-matter, 
not in the vulgar show bill or sensational yellow journal sense, 
but in the sense of emphasizing the central idea, the salient features 
of his work. A statue, said Victor Hugo, is a nudge to ignorance, 
and as the avowed intention of all scientific procedure is a labor- 
saving one—to economize effort and prevent the dissipation of 
energy — we have a right to expect that a title shall be a guide- 
post to something we are not looking for as well as something 
we want to know. The success of such a title depends, in the last 
analysis, upon the words of which it is composed, that is, it is 
mainly a question of medical terminology. A science is said to 
consist of a number of ascertained facts, the ideas which repre- 
sent or interpret these facts and the words or symbols which 
stand for these ideas. In choosing words, the first rule to be 
observed is that we should avoid as far as possible any terms 
which do not represent some definite, tangible thing to the mind. 
Whenever many different remedies are proposed for a disease, it 
usually means that we do not know how to treat the disease; 
similarly, when we see a cloud of new terms introduced to repre- 
sent some indefinite idea or thing, we may be sure that its real 



)vGoO'^lc 



FIELDIXG H. GARRISON, M. D. 5; 

nature is not clearly understood. Words are only labels for 
things at best, and if we invent some new term for an obscure 
conception we are only concealing our ignorance from ourselves, 
if not from others, by pasting on new labels, which may be the 
wrong ones. Talleyrand said that words were made to conceal 
our thoughts, but if science employs words to conceal its ignor- 
ance, it lays itself open to the sneer of Mephistopheles, 
"Denn eben wo Begriffe fehlen 
Da stellt ein Wort zur rechten Zeit sich ein." 
Professor Allbutt, in referring to this "inveterate disease of 
mistaking words for things" thus describes the relation of the 
man of science to the material universe : "The watcher, while tlie 
stream whirls past, endeavors to throw labels upon its infinite and 
fleeting paits; some of the labels stick rightly, others stick in 
wrong places ; others again float along space, as if attached to 
something, but signify nothing,"* In endeavoring to make our 
words convey our real meaning, a good criterion of reality is the 
distinction made in formal logic between what a word or symbol 
denotes, i. e., what it stands for, and what it connotes — the sec- 
ondary ideas or implications which it carries to the mind. For 
example, the Argyll- Roberts on pupil denotes a certain condition 
in the eye, but it may connote tabes or general paralysis. To 
German bacteriologists the expressions TC, TGL, TO, TOA, 
TV, TX, TR denote different and definite varieties of tubercu- 
lins, but they mean nothing in particular to English-speaking 
people. Probably no scientific term has caused so much discus- 
sion as the single word "entropy." To physicists it denotes a 
definite mathematical relation. Exactly what it connotes no one 
has yet been able to define. To our individual minds, what a 
word denotes is commonly the illusion, what it connotes the reality, 
and most controversies turn upon the simple fact that identical 
words mean different things to different people. "Your facts are 
theoretical moonshine, my facts are real things that have hap- 
pened in my own experience." A specialist, therefore, who has 
studied well into his subject, should be cautioned against taking 
his readers too much for granted. It is true that technical terms, 
like the formulse of mathematics, or chemistry, presuppose the 
"properly constituted mind" in the reader, but in the case of 
medical literature, not all minds have been prepared in advance, 

"Lanect, Lone., 1906, 11, iisi; 



)vGoo'^lc 



58 ON EDITORIAL REyiSION OF TITLES. 

at least not to the extent which some titles would apparently 
assume or imply. 

A second good rule in the choice of words is contained in 
the by-word of Julius Caesar, which is observed by all men of 
the world; to avoid an obscure or unusual expression as a navi- 
gator would a rock — Insolens verbum, tanquam scopulum, evitare. 
Coleridge said that '"unfamiliar names are non-conductors and 
stop all interest," and the truth of his aphorism can be tested in 
our own experience by our sensations when asked the familiar 
question, "Do you know so-and-so?" If it happens to be some 
one we have never heard of, it would be idle to say that we ex- 
perience any special interest or emotion at the mention of his 
name. There are two classes of medical terms which are often 
much abused and misused in this respect ; namely, terms derived 
from the Greek and the eponymic expressions, derived from 
names of persons. By common consent, the Latin names, where 
possible, are the best for international nomenclature, as the ver- 
nacular are more suitable for uses nearer home. The objecUon 
to coining new-fangled expression from the Greek are, first, that 
they are by no means easily understood, even by learned Thebans ; 
and, second, they are so frequently devised by incompetent hands. 
Expressions like ageusia, akathisia, allocheiria, ateleiosis, atremia 
are the sort of thing that make the weary reader squirm in his 
chair and reach apprehensively for his medical dictionary, mut- 
tering all the while the prayer of the poet to be "anywhere out of 
the world." Dr. Achilles Rose has done signal service to recent 
medicine by preaching in season and out of season against the 
use of barbarisms from faulty Greek etymologies, especially such 
misbegotten hybrids, half-Latin, half-Greek, as appendicitis, auto- 
digestion, electrocution, radio-therapy, etc.; but it is to be feared 
that he is as one preaching to the desert, for not only does it 
happen that the skilled clinician, the accomplished surgeon, has 
often "small Latin and less Greek," but, what is most significant, 
he concerns himself little about it. Let a word, never so badlv 
put tf^elher, once become popular through common usage and it 
is likely to stick and to thrive. To take a case in point, the term 
"appendicitis," in strict etymology, denotes nothing. It is an 
unscholarly, hybrid expression of obscure and even illegitimate 
origin. But it is a far better term than perityphlitis, or any of 
the other equivalents proposed, because, to the American sur- 



)vGoo'^lc 



FIELDING H. GARRISON, M. D. 59 

geon at least, it connotes the exact pathological condition which 
Fitz described and McBumey showed how to diagnose. It is 
therefore a real ward, standing for a real thing, and has won 
its way to general acceptance. Another etymology whidi is most 
unfortunate is the term "anaphylaxis," for increased suscepti- 
bility to the toxic effects of normal blood serum. In its literal 
derivation, anaphylaxis means the same thing as prophylaxis — 
increased protective power against something — althiMigh it is 
supposed to imply its luteal opposite. It is therefore wholly 
iOaccurate, if hyper-susceptibility to toxic effects of blood serum 
is to be understood as something different from diminished im- 
munity to toxins. Still the word anaphylaxis seems to be gaining 
ground daily and is probably here to stay. Gould is right, then, 
in insisting that it is sheer pedantry or literary snobbery to reject 
a good word on account of its origin, for what it c<Hinotes to each 
and every, one of us is the real thing. In the matter of words 
still uncoined, still unborn, the contention of Dr. Rose seems 
fair, and it were well if every newly proposed etymology from 
the Greek could be first submitted to some Amphictyonic Council 
of medical scholars, who might pass upon its derivation and ac- 
curacy before it is thrown into general circulation. 

In approaching the vexed question of medical eponyms, we 
are reminded of the dry remark of Thoreau at the beginning 
of his Canadian itinerary: "I will not stop to tell the names of 
my fellow travellers; there were said to be fifteen hundred of 
them." The number of medical terms derived from names of 
persons is constantly on the increase and this is the principal 
objection to their continued use in most cases. Doctors Barton 
and Wells, of Washington, who are completing a dictionary of 
medical eponyms. which will prove invaluable to the student and 
the medical editor, tell me that their collection numbers upwards 
of fifteen thousand such expressions. This holds out an appalling 
prospect for the future, when we consider how much valuable 
time has to be wasted in memorizing useless terms. Much has 
been written against the use of eponyms in general, and the fol- 
lowing may be suggested in brief. In the class-room and the 
clinic, it is very fitting and proper that eponymic terms should be 
employed, for among students expressions hke Stokes-Adams 
syndrone, Skoda's resonance, Hutchinson's teeth, are likely to 
awaken and stimulate a lively interest in the history of medicine. 



)vGoo'^lc 



60 OAf EDITORIAL REFISION OF TITLES. 

In medical literature the use of eponyms should be restricted to 
those which have become common and well known, and, where 
a new or unusual eponym must be employed in a title, it ought to 
be followed by the bracketed synonym, for the reader's con- 
venience. As a rule, the best eponymic adjectives are those which 
describe same definite condition or thing, as Colles' fracture, 
Syme's amputation, Charcot's crystals. Applied to diseases in 
general, they lead to great confusion. Thus four different dis- 
eases are described by the name of Percival Pott, and exoph- 
thalmic goitre has four eponymic names in as many different 
countries. In the case of the pathogenic bacteria and protozoa, 
the use of eponyms is still more confusing. Dr. George M. 
Gould has given quite an extensive list of well-known bacteria, 
each of which is eponymically ascribed to more than one person 
or discoverer.* 

To avoid this kind of thing, botanists and zoologists have 
adopted a definite rule which physicians should follow, the so- 
called "law of priority," in virtue of which a generic or specific 
name in natural history is attributed to the man who first be- 
stowed it and not to the man who first described the organism 
in question. As Stiles points out, we credit Theobald Smith with 
the discovery of the parasite of Texas fever, but we do not give 
him credit for its name (Piroplasma hominis) because he did not 
name the parasite correctly in the first instance. If zoologists 
did not locate responsibility in this definite way, the original 
discoverers of different organisms would be wrongly credited 
with scores of different names used by other writers. As consid- 
erations of time and place forbid me from going into the compli- 
cated subject of zoological names, I would strongly recommend to 
all interested in this matter the important monograph of Dr. 
Charles W. Stiles on "The International Code of Zoological 
Nomenclature," which gives a full account of the rules and con- 
ventions adopted in naming animal organisms. 

There has been of late years a praiseworthy and increasing 
effort to improve and systematize the nomenclature of the dif- 
ferent branches of medical science. As a good example, let me 
instance the B. N. A. nomenclature of anatomy adopted by the 
Anatomical Society at Basle in 1895, the results of which have 
been admirably set forth in Dr. Lewelly F. Barker's "Anatomical 



)vGoo'^lc 



ALFRED S. BVRDICK, M. D. Gl 

Terminology" {1907), It will be a long time before such re- 
forms as these are taken up by the profession in general, and 
it is obviously a field in which medical editors and teachers 
ought, first of all, to be pioneers and leaders. In such an in- 
dividual matter as the choice of words human nature is apt to 
follow its own bent at all times and places. When Buffon said 
Le style, c'est I'homme, he meant that each person is a law unto 
himself in these matters. The effect of this tendency upon 
medical titles issometimes confusing, as illustrated by the remark 
of a learned librarian that "the whole world seems to be in con- 
spiracy against bibliographers." Setting aside altruistic motives, 
some appeal to the self -regarding feelings of the medical author 
might be made through the simple fact that as a diffuse long- 
winded book is seldom read, so there is little to stimulate interest 
in an obscure, ambiguous or wordy title. The whole has been 
well summed up in an aphorism of Virchow which asserts that 
brevity in writing is the best insurance for its perusal: Kiirze 
ist die stdrkste Biirgschaft dafUr gelesen su werden. 



MEDICAL-JOURNAL TECHNIC. 

By Alfred S. Burdkk, M. D., Chicago, 111. 
American Journal of Clinical Medicine. 

LOOKED at from a practical standpoint, one of the most 
important papers ever read before this Association was that 
on Medical English, presented by Dr. George M. Gould, at 
the Atlanta, Georgia, meeting in 1896. This paper, with a 
large amount of valuable additional matter, was reprinted in his 
book, "Suggestions to Medical Writers," which appeared in 1900. 
At the time of its publication I had been engaged in medical jour- 
nalism only a little more than a year and was anxious to improve 
my technical knowledge of the profession to which I have ever 
since been attached. Gould's book vi-as a Godsend to me at that 
time and ever since has been in constant use for reference. Its 
value consists not only in the wealth of information concerning 
the correct composition of medical English, but it brings home 
the importance of the utmost care in the detail of everything con- 
nected with the making of a medical journal, something which 1 
fear is very often thought of minor importance by medical editors. 



jvGoo'^lc 



62 MEDICAL JOURNAL TECHNIC. 

While no one can question the paramount importance of mak- 
ing the editorial leaders and the original contributions strong, 
logical, aggressive and interesting, yet I feel convinced that a 
journal with all these features, radiating erudition on every page 
and sparkling with editorial brilliancy, will be a lamentable failure 
from the standpoint of the accounting room unless it is made 
typographically and artistically attractive. As it is hard to see 
beauty in a face decorated with rhinophyma, so it is almost equally 
difficult to take seriously an article which is ungrammatical in 
construction, filled with typographical errors or spoiled by 
smutchy, unattractive printing. 

All the technical details which I shall refer to are considered 
from a certain psychologic standpoint. We want people to read 
our Journals. For that reason we desire, first, to attract their 
attention ; second, to hold it. The little points to which I shall call 
attention, many of them apparently trivial, are insisted upon 
because they seem to contribute to these ends. It would be pre- 
sumptuous for me to give advice about the making of a journal 
to a body of men like this. Please consider the following sug- 
gestions as suggestions only, and all of them very elementary 
indeed to men who follow our profession. 

For convenience let us commence at the very beginning: 

The first thing one notices when. picking up a magazine is 
the cover. It should mirror the character of the journal as far as 
possible. It would be in poor taste for a severely scientific jour- 
nal like The American Journal of Obstetrics to come out with a 
three-color cover with a design emblematic of its peculiar special- 
ty ; nor would a popular medical magazine like our own, which 
appeals to the personal side of its readers quite as much as to the 
professional, be in keeping inside and outside with a plain black 
and white cover. 

If possible the cover, even if severely plain, should appeal 
to the artistic sense, so as to leave a pleasing impression. There 
should be something distinctive about it, so as to rivet the atten- 
tion and lead to the turning of the page and a study of the con- 
tents. For the purely scientific publication the simple announce- 
ment of its most important article may do the work; for the 
popular a picture or a sentiment is more appropriate. Advertis- 
ing on the first cover in my opinion usually cheapens and repels, 
whatever attraction the cover may possess being absorbed by 



)vGoo'^lc 



ALFRED S. BURDICK, M. D. 63 

the advertised article rather than by the journal itself. If the 
space is worth the price to the advertiser, it should be worth more 
to the publisher. 

Paper: — Of all economies poor paper is the worst. More 
than anything else it suggests to the reader the idea of poverty — 
in quality of contents as well as in purse. If economy is necessary, 
better make the journal small and good rather than big and cheap. 
Never try to run halftone illustrations on rough paper. If your 
photographs are fine they deserve enamel stock or at the very 
least a good quality of supercalendered paper. If illustrations 
are not used, then a soft not too rough paper of good quality 
should be used. It is not only more agreeable to the eyes, but 
gives bulk without weight, sometimes very desirable. 

Type: — My personal preference is for lo-point type, leaded. 
Anything smaller than this is not easily read by persons with re- 
fractive errors or of advanced years. The ideal type is not yet 
available. 

It has been shown experimentally that the letters which are 
read with the greatest difficulty are those used most frequently. 
viz., e, a, i, n, s, t, while e, the letter most used, stands at the 
very foot in the distance-group. 

This difficulty may possibly be overcome by future changes in 
their form, but present help is secured by using larger-sized type. 
Increase of one size in type increased the legibility more than 13 
per cent, according to some experiments made by Professor Scott 
of Northwestern University, with a reduction in the number of 
errors in reading of about 45 per cent. 

Columns : — From the standpoint of legibility the column 
should be relatively narrow. Dr. Casey A. Wood places the max- 
imum of length of line for school books at 45^2 inches with 10- 
point type, but even this is too long for ease of reading. The 
line should be short enough so that the eye does not have- to make 
a conscious effort to follow it across the page. Every increase' 
of ocular effort represents a corresponding Iqss of interest. The 
longer the line the larger should be the size and the greater the 
amount of space, or of the leading, between lines. I am confident 
that a careful test would show that taking lO-point type as our 
standard, unleaded, the reading of a line longer than three inches 
in length represents recognizable waste of energv ! Of course 
the smaller the type, the shorter the line should be. 



jvGoo'^lc 



G4 MEDICAL JOURNAL TECH NIC. 

The standard newspaper colnmn of i3!/2 ems (2% inches), 
while wrought out in the school of experience, is not the result 
of mere guesswork. Scott, already quoted, declares that the eye 
can grasp only about fotir words at a time. A careful trial will 
convince you of the truth of this statement. An average newspa- 
per line containing about 7 or 8 words, considering the mechani- 
cal difficulties involved in composition and the spacing between 
words, represents the least possible ocular readjustment from 
word to word. 

Paragraphs:—! confess that, in reading, few things annoy 
me more than the excessively long paragraph. It is common to 
pick up a medical journal and find whole pages without a single 
break. To me such a page presents a formidable barrier, one 
that only an exceedingly attractive subject or an unusually clever 
method in presentation can break down. The eye wanders over 
the bewildering desert of black and white and not one oasis or 
resting place presents itself. The result is that when the thread 
of argument is dropped the reader rarely tries to pick it up again. 
He throws down the magazine in disgust, and votes an otherwise 
readable article a bore and author and editor fools. 

There are, of course, natural places for paragraphing, these 
representing changes in the current of thought, but it is rarely 
necessary to confine oneself to these. It is an unusual article, 
indeed, where a paragraph can not be begun almost anywhere. 

"Yellow" journalism is responsible for very short paragraphs, 
some of the editorials now being so broken up that practically 
every sentence stands alone. This is carrying the matter pretty 
far; still, I confess to a weakness for rather short paragraphs, 
especially in editorial matter, in which a certain dramatic force 
can often be brought out by letting a single sentence stand out 
absolutely by itself, following a paragraph of usual length. 

Captions: — Two things are desirable in the caption of an 
article: (i,) It should tell something definite about the character 
and scope of the article and (2), it should possess attraction 
enough to make the'reader want to read it. Admitting the truth 
of the statement of Professor Scott, the ideal title should contain 
not to exceed four words. There are articles with which such 
brevity is impossible — but, other things being equal, the shorter 
they are, the better. 

I like a sub-title. It should contain a brief abstract of the 



)vGoo'^lc 



ALFRED S. BURDICK, M. D. (io 

argument, thus saving the reader's time, while stimulating inter- 
est. The sub-title is, of course, a newspaper idea, somewhat 
modified to meet changed conditions. In the newspaper the title, 
sub-title and first paragraph together tell the whole story. The 
remainder of the article is but the filling in of detail. It is ex- 
pected that knowing the outline of fact the reader will desire to 
know the detail. 

Subheads: — The ideal medical article should be short, so as 
to hold the reader's attention to the end. If it is necessarily of 
some length, the next best thing is to introduce catchy subheads 
which really subdivide it into a number of shorter articles, each 
fairly complete and presumably interesting in itself. The popular 
magazines were first to make use of this trick to hold the wavering 
minds of their readers, when they commenced to print scientific 
and other heavy articles by celebrated men. The subheads made 
them readable. Without the subheads from a pc^ular stand- 
point they were impossible. 

Illustrations : — Pictures may add a great deal to the value 
and attractiveness of a medical journal. If poorly made or poorly 
printed they are worse than useless. This is particularly true 
of medical subjects, such as the halftones designed to show stages 
in operations The original photographs or washdraiwngs should 
be clear and sharp, and should possess real illustrative value. 
While for our publication we have made many halftones from 
the gaslight photograph papers; these are generally unsatisfac- 
tory, since they do not bring the detail out as clearly as the sun- 
light papers. 

The ideal paper-stock for halftones is, of course, the enam- 
eled ; next is machine-finished supercalendered paper. Give your 
electrotyper a sample of your paper, and tell him to fit the screen 
to it ; with this knowledge he can sometimes get really excellent 
results with otherwise unsatisfactory materials. Do not, under 
any consideration, try to print halftones on rough paper. 

Much depends upon how a photograph is displayed as to the 
effect produced by it. A small cut may be made to appear 
larger by framing with brass rule ; one of odd shape by running 
the type around it ; while a very important cut should always 
be centered on the page, if possible. 

The illustrations in medical journals are as a rule very unsat- 
isfactory. There is one very striking exception, namely, "Sur- 



)vGoo'^lc 



«C MEDICAL JOURNAL TECHNIC. 

gery, Gynecology and Obstetrics," which artistically as well as 
typographically leaves little to be desired. Some of us would 
like to know how Dr. Martin does it — and makes the ledger 
balance. 

Preparation of Copy : — I very much fear that in a very large 
percentage of cases medical-journal copy goes to the printer un- 
edited, with the expectation that the intelligent compositor will 
correct the errors of the writer — in other words, do the editor's 
work. This careless handling of manuscript may be excusable on 
the part of an editor to whom the making of a journal is a mere 
diversion, but never if it is his regular business in life, 

j4lf copy should be edited, no matter how caerfully prepared 
or how accurately typewritten, not merely to correct errors but 
in order to secure uniformity of style. Our own custom is to 
have all our copy which comes to us in longhand, or poorly or 
closely typewritten, copied on the machine. It is then edited, and 
if there are many corrections it is again typewritten. We take as 
much pains with and almost as many liberties with articles sent 
by trained literary workers as from the roughest of cross-roads 
doctors. 

It is a mistake to over-edit, so as to take the individuality out 
of an article. This is the intangible something which makes it 
alive. I know of one editor of a very great medical journal who 
cuts all this out, — he wants nothing of the personal flavor, he 
says. His journal is as cold and soulless as an iceberg, and while 
it does command respect it wins no affection. 

I want to emphasize right here my own observation that a 
beautifully prepared manuscript sometimes may lead the editor 
astray as to its real merit as much as a poorly and hastily written 
scrawl. Quite often the latter, when re-done and shaped up a 
little, develops an interest and spontaniety as striking as the stilt- 
edness of the over-studied medical essay of the expert. There- 
fore I rarely pass final judgment upon an article until it has been 
done over on the typewriting machine. On the other hand, if I 
wanted to win favor with an editor, I should submit an impecca- 
ble manuscript, type-written, with wide spacing, wide mar^ns 
and frequent paragraphs. 

When I can have my way with writers I request them to put 
in only just enough punctuation marks to make the meaning clear, 
eschewing the use of capital letters and scoring, and requiring at 



)vGoo'^lc 



ALFRED S. BVRDICK, M. D. 6? 

least double type-writer spacing. I prefer myself to mark punc- 
tuation and directions to the printer so as to suit our established 
style. 

Proofreading: — Happy is the editor who has a proofreader 
or assistant upon whom he can lean. Therefore I am happy 
since my assistant is a man of long editorial experience who is a 
real student of the laws of language. Needless to say he is Ger- 
man. The amount of proofreading is in inverse ratio to the care 
in preparation of manuscript — theoretically. However, I am so 
constituted temperamentally that I cannot read a proof without 
making changes ; my assistant is worse — ^and Dr. Abbott is about 
four hundred per cent worse than he. Therefore I am glad when 
the Doctor is "extra" busy when the "forms go on." 

The easiest mistake to make in the world is one in proof- 
reading, and though our own matter is read by at least three peo- 
ple and by two of these at least twice each, I never yet have 
picked up a journal, I think, without discovering an error of some 
kind. Happily we have never been guilty of as serious a one as 
that of the Medical Record, which some years ago, through the 
placing of a P for an R announced an "Epidemic of Babies in 
Washington, D. C, or the Journal of the American Medical 
Association, which in the condensed table of contents on its cover, 
shortly before the death of the late Dr. N. S. Davis, gave as the 
subject of his leader: "Poverty, Pregnancy and Crime, their 
Cause, Prevention and Cure." It is said that the substitution of 
the word "pregnancy" for "degeneracy," which Dr. Davis had 
really written, was the cause of his untimely demise. 

Style : — A whole book might be written on medico-literary 
style; indeed, an excellent one has already been written, Dr. 
Gould's. I can only hint at a few things : 

So far as our journal is concerned, we want simplicity. What 
I or my immediate neighbors can not understand readily, the 
probabilities are a good many others cannot. Therefore, I prefer 
short sentences. Instead of long sentences which no one but an 
opera singer can read in their entirety without catching breath, 
I try to break the matter up into short, incisive ones. This can 
usually be done without mutilating an author's copy. 

Of two words equally descriptive always use the shorter 
one. If it "savors of slang," do not let that worry you. Slang 



)vGoo'^lc 



68 MEDICAL JOURNAL TECHNIC. 

is the living tongue of the people and sparingly used adds a touch 
of spice. 

Avoid quotations from foreign languages. As usually inter- 
polated they voice the pride of pedantry rather than the humility 
of wisdom. Few readers understand them, and your journal 
exists for its readers, not for its contributors. The same sugges- 
tion may be adc^ted with regard to much so-called scientific ter- 
minology. Too often it is used to mystify rather than to en- 
lighten. 

We had an interesting discussion in CLINICAL MEDICINE 
some months ago over the use of Latin in prescriptions. When 
the whole argument for the defendant was summed up it was 
found that the only real excuse for Latin is to hide knowledge 
which possibly might be enlightening to the patient — such as let- 
ting him on to the fact that he is paying $i.oo for a nickel's 
worth of sweet spirit of niter. Gould shows that the whole sym- 
bolism of prescription writing goes back to the signs of the 
Zodiac and medieval astrology. Even the well-known crossed 
"R" with which every well-bred prescription must commence, is 
an abbreviated invocation to Jupiter — a sort of "God save us" — 
presumably from what follows. 

Styles in spelling, the compounding of letters and punctua- 
tion, I cannot discuss here. They require exceeding care on the 
part of editor and proofreader. While my sympathies are with 
the reform movements along these lines, I hardly think that it is 
the function of the medical journal to take an advanced position, 
though 1 know Dr. Taylor will not agree with me. We use the 
simplest of the accepted spellings, avoid the use of hyphens, mak- 
ing most compound words solid, especially when they are com- 
posed in part of a Latin prefix, and employ a moderately "open" 
punctuation. Every journal should work out a typographical 
"style" of its own and stick to it. I want to protest against the 
custom, adopted from the Germans, of spelling alkaloids without 
the terminal "e." This makes for confusion instead 'of sim- 
plicity. 

I also wish to urge the necessity of care in the spelling of 
proper names. In our own journal, which every month has orig- 
inal contributions from fifty to seventy-five different physicians, 
we have to be very cauti'Ous, and still we make mistakes. A man 
will forgive almost anything sooner than the misspelling of his 



)vGoo'^lc 



ALFRED S. BURDICK, M. D. 69 

name. Citations from foreign authors need special caution. With 
some Journals it seems to be the exception rather than the rule to 

spell. these names right. 

Finally, I want to say that the time spent in a study of 
English, and especially medical English, is well spent on the part 
of any man who is engaged in medical journalistic work or in 
writing for the medical press. 

Of the books which I have found useful I may mention 
the "Stylebook of the Chicago Society of Proofreaders," "Notes 
for the Guidance of Authors," published by Macmillan {spelling, 
very English); "The Preparation of Manuscript," Vizetelly; 
"Punctuation," Teall ; "Practical Journalism." Shuman; "Sug- 
gestions to Medical Writers," Gould. We use the Standard Dic- 
tionary; and for medical words Dunglison, with Gould and 
Foster for reference. 

DISCUSSION ON DR. BURDICK'S PAPER. 

/. /. Taylor — While I wish to commend the entire paper, two points 
appealed to me particularly. This paper is one of the most practical ever 
read before the association. The first point thai I wish particularly to 
commend is the spelling of alkaloids. I have always felt it was a great 
mistake to drop the final "e," thereby not enabling us to distinguish be- 
tween an alkaloid and an active principle. The second point is citation of 
authors. I have always made it a practice to give full names and addresses 
so that any reader desiring to correspond with an author might do so 
without first getting in touch with him through the journal office. The 
necessity for this and for great care in the writing of names and addresses 
ii because many American authors are quoted in foreign journals. I re- 
member about 14 years ago I read a very practical article by Dr. Wm. F. 
Waugh. It was pretty well quoted all over this country and in Germany 
and the simple name "Waugh" used as a signature. Some American author 
in copying it from a German paper, not connecting it with the paper so 
much quoted in this country, spelled the name "W-r-a-n-g-l-e." If you 
will write Waugh hurriedly and carelessly you will see how easy it would 
be to read it this way. Now if all editors would give full names and ad- 
dresses, thereby giving authors credit, Ihey would also enable their readers 
to identify the authors as well as communicate with them if they care to. 

C. F. Taylor — It has never been my pleasure to listen to a paper 
which so entered into our daily work as this does. Concerning the final 
"e" at the end of an alkaloid : I have followed the simplified -spelling rule 
to drop it because that rule has been adopted by the American Chemical 
Society and I have left to them the decision of so technical a point with 
which they are supposed lo be more acquainted than anyone else. I know 
eclectics are opposed to it because they wi.sh to draw a dividing line be- 



:„,;.. b/GoOt^lc 



70 ESPERANTO IN MEDICINE. 

iween alkaloids and glucosides t>y the use of the final "e," but I have 
looked upon the society mentioned as being good authority for the spelling 
of a word, 

/. /. Taylor— I would like to answer that. There is a bigger dif- 
ference than that mentioned and a better authority to go to than the one 
quoted. The alkaloids are feminine and end in inc. The princii^es that are 
not alkaloids are masculine and end in inus. Therefore, in English we 
have made the distinction of using the "e" to denote feminine words and 
"in" for the masculine. 

President Crolhers — Personally I do not like to see Latin and Greek 
words and phrases in a paper. It lodks as if the author lacked proper 
knowledge of his subject and was trying to cover up his ignorance. 

W. F. Waugh — I would like to revert back again for a moment to 
the spelling of alkaloids which is really a very serious matter. The prin- 
cipal thins we should bear in mind is that the onussion of the final "e" 
sometimes spells death for our patient and I believe no society ever goes 
60 far with a physician as the possibility of endangering the life of his 
patient. 

A. S. Burdkk (Closing remarks)— I think that in the main the 
points criticised have been answered and there is nothing more that I wish 
to say except that I do not consider the American Chemical Society very 
good authority, especially in view of the fact that the U. S. P. for good 
and sufficient reasons has adopted the difference in spelling. It is simply 
a matter of distinguishing between two classes of preparations, as Dr. 
Waugh has said 

I could have gone into many other technical points, for the subject 
is one which has always interested me, of course, as it is my daily work 
and my bread and butter. I see it so much neglected (if I may say so) in 
the average journal. That is not a very nice thing to say, but I believe 
that the average journal is not well edited and the proof reading is often 
abominable. 



ESPERANTO IN' MEDICINE. 
By Kenneth W. MiUican, BJi,, M.R.C.S., Faxrlee, Vt 

I WILL not insult the intelligence of this audience by discussing 
the question whether some mode of international communica- 
tion, which, being learned, shall put all nationalities once 
for all in possession of a means of c:>mmunication with 
regard to every kind of foreigner, is or is not desirable. The 
evidence that it is, is too overwhelmingly apparent, and in nothing 
more than in the international congresses that have now become 
so important a feature of every activity of life. This is the 
age of internaticMialism, and consequently of the need of methods 
of international intercommunication, and the hindrace thereto 



jvGoo'^lc 



KENNETH W. MILLICAN, M. D. n 

afforded by the diversity of tongues has been too loudly and widely 
lamented to admit of any doubt on the matter. I shall, there- 
fore, confine my considerations to the question whether such a 
mode of internatitmal communication is practicable, and if so, in 
what direction it should be sought for. 

There are three possibilities: r. The restoration of a dead 
language, which practically means Latin ; for to speak of re- 
introducing the classical form of Greek would naturally be met 
with a smile of derision, though modern Greek has its advocates — 
it is a living language, and, therefore, will be included under 
the next category. 2. The selection of some existing living 
tongue. 3. The invention of an artificial language, to be learned 
as an auxiliary to their mother tongue by people, and especially 
by the children, of all nationalities, so that one tongue shall be 
all that is required to enable them to communicate with foreigners 
of whatever nationality. 

1. To Latin the obvious objection is that it is too difficult 
for the majority to learn at all; and even the fairly well edu- 
cated, who have taken a classical course at school and college, 
know from their own experience that their capacity to converse 
in it is practically mi. Even for those of more than ordinary 
education, to master it sufficiently to be able to converse in it 
would require more time than they could well afford to give to 
it. Moreover, Latin is daily growing more and more out of 
gear with the needs of modern civilization. It would, therefore, 
be necessary materially to alter it in two important respects: 
viz., first, by simplifying the grammar to such an extent as 
entirely to alter its structure ; and secondly, by importing so 
much foreign material into it that it would no longer be Latin. 
It would thus become practically itself an artificial language. 
But, if we are to have an artificial language at all, it is surely 
better to construct one up to date, rather than to attempt to 
"put new wine into old bottles." 

2. The selection of an existing national language has in- 
superable difficulties. First, there is the difficulty of learning any 
foreign language, which all persons, of whatever nationality, ex- 
perience in a greater or less degree. Let any one of you who 
has learned more or less well any language other than his own, 
ask himself whether he thinks that there is the least probability 
of the great masses of the people of any nationality, or even the 



)vGoo'^lc 



7S ESPERAXTO IX MEDICIXE. 

great mass of any learned profession, being able to acquire a 
mere speaking acquaintance with any second national language. 
When you contemplate going abroad for post-graduate study, 
are you not cautioned that it is largely waste of time to go to a 
foreign country with the language of which you have not a 
fair acquaintance, lest the whole of the time you can allow 
yourselves be entirely taken up in learning enough of the lan- 
gxiage to profit by the medical teaching, before il is time to go 
home. 

But there is an even greater difficulty. I cannot do better 
than state it in the words of a thesis for the M D. of Paris, 
by a French physician, Dr. Pierre Corret, of whom more anon. 
He says : "Truly, French would offer great advantages ; that we 
cannot deny. Its intrinsic qualities render it, indeed, eminently 
fitted to treat of scientific subjects. Its adoption would relieve 
us (the French) of the necessity of studying any foreign lan- 
guage, and only the other people would have to learn ours. 
What advantages the selection would give us! The time that 
foreigners devoted to studying our tongue we should have to 
use for scientific research, and the official recognition of French 
as the international language would confer on us an incontestable 
advantage over all the other nations. 

"But," he continues, "it is just these advantages to the profit 
of the nation whose language should be chosen, which will al- 
ways prevent the different peoples from coming to an agreement 
on the adoption, as an international tongue, of that of any one 
of them." 

There are some who fondly believe that time will solve the 
problem, by making English the international tongue; and doubt- 
less it is destined to spread very widely; but the time of its 
hoped-for supremacy is yet a long way off, and meantime the 
need for such a tongue presses, and becomes daily more and 
more urgent, owing to the rapidly increasing inter-communication 
of the nations. And in nothing is that need more acutely felt 
than in the cosmopohtan republic of the sciences, not the least 
■ important of which is medicine. 

The third possibility, therefore, remains, viz., the construc- 
tion of an artificial language, which shall be io simple that the 
least educated can learn it with ease, and without any ov«r- 
taxing expenditure of money, time, or effort; so flcrible that 



)vGoo'^lc 



KEMXETH IV. MILLICAN, M. D. 73 

it can be made, without violence to its natural genius — such as 
wouid have to be used in any attempt to impress into service a 
bastard Latin — to express anything that the mind of man can 
conceive; and so accurate that, if employed according to rule, 
it can express the most exacting ideas with precision and without' 
ambiguity. Many artificial languages have been offered, be- 
ginning with the Logopandekteision of Sir Thomas Urquhart, 
in 1653. and finishing up with a batch, 49 in number, that have 
burst upon the world since Bishop Schleyer, in 1879, first pro- 
mulgated Volapiik. But of all these, the only ones that have 
ever gained any practical following at all are Volapiik— which 
died a natural death from its complexity of structure and vocab- 
ulary, and from the claims to ownership made by its author; 
and Esperanto, which in consequence of its extreme simplicity — 
it has been aptly termed the "least common multiply of lan- 
guages" — is now fast progressing towards its aim. It is of 
Esperanto that I shall now speak ; and I claim for it that it 
possesses in a marked degree the three qualities that I have out- 
lined above as being necessary, 

Esperanto was invented by a Polish physician, Dr. L L. 
Zamenhof, who, under the pseudonym of Dr. Esperanto, after 
very many years of unobtrusive study and unwearying labor, first 
promulgated it in 1887. It did not, however, receive any ap- 
preciable public recognition until after the first International 
Esperantist Congress, held at Boulogne, France, in 1905. That 
congress was attended by 800 Esperantists from very many 
countries, all nervously anxious to see how the new means of 
inter-communication which they had been learning, some of them 
for only a few weeks, and nearly all from books alone — there 
were naturally no teachers in those days — would work out in 
practice, when tried face to face with foreigners speaking dif- 
ferent mother tongues, with pronunciation, accent, and idioms, 
differing from one another. 1 cannot do better than, with your 
permission, read a brief description of that momentous event : 

"On Saturday evening, August 5, at 8 o'clock, the Boulogne 
Theatre was packed with a cosmopolitan audience. The unique 
assembly was pervaded by an indefinable feeling of expectancv; 
as in the lull before the thunderstorm, there was the hush of 
excitement, the tense silence charged with the premonition of 
some vast force about to be let loose on the world. After a few 



)vGoo'^lc 



74 ■ ESPERANTO IN MEDICINE. 

preliminaries, there was a really dramatic moment when Dr. 
Zamenhof stood up for the first time to address his world- 
audience in the world-tongue. Would they understand him? 
Was their hope about to be justified, or was it all a chimera, 
■ such stuff as dreams are made on? 

" 'Gesinjoroj' (i. e., ladies and gentlemen) — the great au- 
dience craned forward like one man, straining eyes and ears 
towards the speaker — 'Kum grdnda piesuro mi akciptis la 
prop6non. . .' The crowd drank in the words with an 

almost pathetic agony of anxiety. Gradually as the clear-cut 
sentences poured forth in a continuous stream of perfect lucidity, 
and the audience realized that they were listening to, and all 
understanding, a really international speech in a really interna- 
tional tongue, which secured to them, as here in Boulc^e, so 
throughout the world, full comprehension and a sense of com- 
radeship and fellow -citizen ship on equal terms with all users of 
it — the anxiety gave way to a scene of wild enthusiasm. Men 
shook hands with perfect strangers, and all cheered again and 
again.'" 

"At the BouI<^ne Congress Le Mariage Force of Moliire 
was played in Esperanto by a cosmopolitan cast ; thus the 
Sganarelle and the Geronimo were French ; Dorimene was an 
Italian ; Alcantas, a Belgian ; Alcidas, a German ; Licaste, a Nor- 
wegian ; Pancrace, English ; Marphurius, French Canadian ; and 
of the two Bohemian women one was Swedish and the otlier 
Russian Yet with only two rehearsals this company played so 
that the nationality of the players could be divined in only one 
case, and that was the Enghshman who gave himself away when 
he pronounced, after the English fashion, the Latin words that 
occur in his part.'" 

In the following years congresses were held at Geneva, 
Switzerland (1906), at which 1,000 were present; at Cambridge, 
England (1907), with 1,400 in attendance, the Belgian Govern- 
ment sending an official delegate ; and in August, 1908, at Dres- 
den, Germany, attended by upwards of 1,500 petqjle. representing 
42 different languages and nationalities, to which official delegates 
were sent by the Governments of Japan and the United States. 
A delegate was also in attendance from the International Com- 
mittee of the Red Cross who was not an Esperantist, but at- 
tended to give his committee an impartial account of the affair. 



)vGoo'^lc 



KENNETH W. MILUCAN, M. D. 75 

From the report of this delegate, let me quote the following 
passages : 

"Dr. Thalwitzer, of Dresden, gave an interesting display, 
at which I had the pleasure of assisting. General Schmidt had 
placed at his disposition a bearer section of the Saxon Red 
Cross. In ten lessons, he had succeeded in giving them sufficient 
instruction to permit of thirty men, who knew only German, exe- 
cuting orders given them in Esperanto, and replying to questions 
put to them in that tongue. . . . 

"Some hours suffice to a person of moderate education to 
apprehend the mechanism of Esperanto. At the end of some 
weeks of study, even without a teacher, one easily is able to read 
it. A few months suffice to understand and speak it fluently." 

Again : "It is very difficult, when listening to a person speak- 
ing Esperanto fluently, to recognize what is his national tongue ; 
that was one of the facts that struck me most in hearing rep- 
resentatives of more than 30 different nations talk." 

The delegate of the United States Government to the same 
congress was Major Philip Straub, of the headquarters staff of 
the Medical Corps of the Army, Major Straub was not at that 
time an Esperantist, though he has since become an enthusiastic 
one. In his report, which was published in the Army and Navy 
Register, January 6, 1909. he says: 

"The Esperanto language is -constructed on such simple and 
practical lines that one can learn to read it in an incredibly 
short time. The rules in grammar are few and as there are ab- 
solutely no exceptions, it requires but a few hours' study to mas- 
ter them. . . . 

"I am quite convinced that Esperanto, which has been on 
trial for twenty years and been found to fulfil the conditions re- 
quired of an international language, is destined to perform an 
important role in international intercourse, and will eventually 
become of great economic value in facilitating trade relations be- 
tween various nations. . 

"From a military point of view, the most important applica- 
tion of Esperanto at this time would appear to be in the sanitary 
service, and I am of the opinion that the government would be 
justified in giving it official countenance. It is suggested that a 
beginning be made by introducing it into the National Red Cross 
Association. . . . The officers of the European Red Cross 



)vGoO'^lc 



76 ESPERANTO IN MEDICINE. 

organizations, especially those of France and Gennany, have 
taken active interest in the propaganda, and many high officials 
of their organizations were present at the congress. 

"It is quite easy to understand, whether spoken by Russian, 
German, Turk, Japanese, or American." 

TTie delegate accordingly urges its adoption into the Ameri- 
can Red Cross, and that the coming National Esperanto Congress 
at Chautauqua, in August (the second that will have been held) 
be given such governmental assistance as may be necessary, in 
order to make it a success. This report and its recommendations 
were officially indorsed by the surgeon-general of the army and 
the secretary of war. 

The next International Esperanto Congress takes place in 
August at Barcelona, Spain. 

WHAT, THEN, IS ESPERANTO? 

Esperanto is made up of a few primary words — definite 
article, prcmouns, prepositions, conjunctions, interjections, and a 
few primary adverbs — complete in themselves, and between two 
and three thousand roots selected on a basis of internationality, 
so that as many words as possible shall be recognizable at sight 
by as many people as possible. These roots become nouns, 
adjectives, verbs and adverbs respectively, on the addition of 
grammatical terminations, which are always the same for the 
same part of speech. Any root, therefore, can be made any one 
or all these parts of speech in turn, if the sense of the root 
permits of it. Thus, the root parol expresses the general idea of 
"speak." Add the noun terminal, o, and it becomes pardl-o, 
speech; the adjective terminal, a, and we get par6l-a, oral; add 
e and we have parol-r, orally; and finally, add i (the infinitive 
termination), and it signifies parol-i, to speak. By this means 
2,000 roots of Esperanto, being as it were multiplied by the 
four grammatical terminations, give us approximately 8.000 each 
of substantives, verbs, adjectives, and adverbs, or nearly 30.000 
words altoegther. without imposing on our memory any other 
effort than that of rccalhng the four terminations — a, e, i. o, — 
with their respective significations of adjective, adverb, infinitive, 
and noun. 

Many of the primary words mentioned above, also, can be 
converted into other parts of sjwech by addition of the respective 



)vGoo'^lc 



KENNETH W. MILLICAN, 'M. D. 77 

terminals ; thus, apud is a preposition meaning "near to," "by," 
e. gi, apud dom6, near a house; but by adding the 
adjective terminal a to apud, the latter becomes an adjective; 
thus, apud-a ddmo signifies "a near-by house." }es (pronounced 
yes) is the affirmative adverb, and means just what it does in 
English. But by adding a, it, too. becomes an adjective, and 
serves where we have in English to use a word from a different 
root; thus: Jes-a respondo, an affirmative answer. J^s-i means 
to "say yes," to "affirm." J&s-o is affirmation. 

Then the verbs, the crux of every language to foreigners. 
They are as simple as the rest. There is only one conjugation, 
and that is very short, and every verb without exception con- 
forms to it. It is formed, as the other parts of speech are, by 
adding grammatical terminations to the root. Thus: as is the 
sign of the present ; is, that of the past ; os, that of the future ; us, 
that of the conditional; u, that of the imperative and subjunctive 
(or dependent) mood. There are three participles — past, present 
and future, for both active and passive voices, the same time 
letters (present a, past, i; and future o) again coming into play. 
Thus, take the verb don-i, to give, we have present, don-as (the 
form is the same for all persons and both numbers, the noun or 
pronoun alone distinguishing sufficiently) ; past, don-is; future, 
d6n-os; conditional, don-us; imperative and dependent, ddn-u; 
participles: active, don-ant-a, don-Uit-a, don-ont-a; passive, don- 
dta- don-it-a, don-ot-a. The participles, too, may be used either 
as nouns, adjectives, or adverbially. Thus kantdnta birdo, a 
bird singing; la kantdnta, the singer (person who is singing) — 
and here is a very fine distinction: !a kantinto means also the 
singer, but the person who was singing ; while la kantonto, means 
the singer, the person who is about to sing. Adverbially, we 
say: Kantanie. li ctirts !a cdnibroii. Singing, he left the room. 

The plural is formed in nouns, adjectives, and participles, 
by adding j (sounded as y) to the o or o with which the word 
ends. Thus, viro, a man ; viroj, men ; bona vera, a good man ; 
bonaj vlroj, good men. The adjective, it will be noted, takes 
the plural termination when its noun does, for a reason that will 
appear when speaking of the accusative. 

The accusative, used to signify the direct object of a verb, 
time, place toward which, price, etc., is made by adding n to 
the 0, oj. a, aj, of the noun and adjective, either singular or 



)vGoo'^lc 



78 ESPERANTO IN MEDICINE, 

plural. Thus: Mi, dmas bonan viron (or bonapi virojn) I love 
a good man (or good men). 

There is 4 real practical value to the accusative, for it allows 
a certain variation in the order of the words, such as would 
cause great ambiguity in English (and sometimes does in poetry, 
etc., where inversion is used). For instance, in the sentence "his 
son the father loves" we are not quite certain whether it is the 
son that loves his father or the father that loves his son. But 
there could be no such doubt in Esperanto, where the meaning is 
at once clear, whether we say la p&tro, amas sian fifon, or sian 
filon dmas la pdlro. Moreover, by being compelled in English, 
in order to avoid misapprehension, to follow strictly the logical 
order of thought in speech, we lose many of those fine shades 
of meaning that used to delight one in one's Greek and Latin 
reading. These the retention of the accusative case in Esperanto 
enables us to retain. 

The last point to mention is the way in which words are built 
up by a system of prefixes and suffixes of invariable meaning, 
which, being interposed between the root and the grammatical 
termination, not only modify the meaning of words, but in- 
crease our vocabulary vastly with but little expenditure of effort, 
by rendering unnecessary many words that in other languages are 
derived from different roots. Thus, the prefix mal signifies the 
exact opposite of anything. Bona being good, malbana neces- 
sarily means bad, evil. Fermi meaning to shut, malfermi means 
to open, and so forth. Again, the suffix hi signifies the female 
of anything that is capable of sex. Viro being a man, a woman 
is necessarily vir-in-o. If, therefore, you know the name of any 
male thing in Esperanto, you know what the term for the female 
must be, though you may never have heard it. Eg and et are 
augmentative and diminutive, etc By this means, one-third of 
the entire vocabulary of most languages is rendered unnecessary 
and there are so many hundred roots less to learn. 

Finally, all the technical and scientific terms, as well as many 
others, derived from the Greek and Latin, which are already 
practically international in fact, are adopted bodily into Esperanto, 
merely conforming to its spelling, as they do in other tongues 
that use them, but in Esperanto the spelling is truly phonetic. 
Thus, therapy becomes terapio, physiology, Hdologio; telegraph. 
tclcgrdfo; astronomy, astronomio; theatre, tedlro, etc. 



)vGoo'^lc 



KENNETH W. MILUCAN, M. D. 79 

As to pronunciation, the vowels take the continental sounds 
of ah, eh, ee, ok, oo; aj is long ; like i in sigh ; oj like oy in boy. 
Some of the consonants vary from English. G is always hard 
as in get. C is like ts in Tsar ; ;' like y ; and there are six new 
consonants to represent the sounds ich as in church, soft g as in 
gem, guttural as in German auch, soft jas in pleasure, sh as in 
shell, and final w as in cow. These new letters are represented 
by c g h ] s and u with a circumflex accent over them. Q, w, x 
and y are omitted. 

In Esperanto there is only one sound to one letter and one 
letter to one sound. Every letter is sounded ; there are no 
silent letters to bother one. And last, and most important of all, 
THE ACCENT IS ALWAYS ON THE LAST SYLLABLE 
BUT ONE, An actual error in pronunciation is, therefore, al- 
most impossible when once the rules are known. 

And that is all there is to it, except to learn a sufficient 
number of roots; which is readily done by reading, seeing that 
about 83 per cent of the roots are easily recognized by an Eng- 
lish-speaking person of moderate education. 

WHERE ESPERANTO STANDS TO-DAY. 
Now, let us look for a moment at what Esperanto has already 
accomplished. Practically unknown, its acquaintance being con- 
fined to a few thousands, if not hundreds, only five years ago, 
before the first International Esperanto Congress at Boulogne, 
it has now probably over a million adherents, divided among 
every civilized country in the world. In November, 1906, there 
were 306 Esperanto societies in the world. A year later, there 
were 639; while in November, 1908, the number had risen to 
1,130, and it lias since increased materially, though I have not 
the official figures available. No less than 28 international con- 
gresses devoted to various pursuits have either endorsed it or 
sanctioned the use of it in their sessions. The Pan-American 
Scientific Congress in Chile, held last January— which you will 
remember was a quasi-governmental affair, being officially par- 
ticipated in by the various governments of this continent, and 
having representation from twenty nations and most of the im- 
portant universities in the two Americas — passed resolutions rec- 
ommending to the respective governments that it be made a 
subject of instruction in all primary schools. The recent Con- 



jvGoo'^lc 



80 ESPERAXTO IX MEDICISE. 

gress of Climatology and Hygiene at Algiers sent out its pro- 
gramme in Esperanto and sanctioned its use for papers and 
discussions. Finally, it has been accepted as an official language 
for papers and discussions at the forthcoming Intcrttalional Med- 
ical Congress at Budapest; and short though the time was, be- 
tween its acceptance and the time limit for the sending in of 
papers, I know of at least six papers that will be presented in 
Esperanto. Other congresses that have undertaken to adopt it 
at their next conventions are the XI Russian Surgical Congress 
of Pirogoff, and the International Peace Society. 

As to education, apart from private enterprise, it is taught 
now at several universities and colleges, including in this country 
the universities of Wisconsin and Chicago, the Boston Institute 
of Technology, and the Roxbury Latin School. It is a subject 
for the local examinations of the University of Oxford. It was 
made part of the regular curriculum in no less than 40 public 
schools of Great Britain last year,- and is part of the regular 
course in several countries abroad; in some instances, as in parts 
of France and Spain, in Cochin China, and some South Ameri- 
can countries, being subsidized by the government. The London 
Chamber of Commerce has included it among the subjects for 
its commercial certificates. England and Russia have adopted 
it as an official language for telegrams. 

In literature, it is represented, not only by national journals 
in 54 nations, but by a literary and a scientific review, both of 
high class; by numerous special journals devoted to such varied 
pursuits as commerce stamp collecting, socialism, Christian en- 
deavor, and for us, the most important of all, the Voco de 
Kuracistoj, or Voice of the Physicians, the official organ of the 
Tuimonda Esperdnla Kuracista Asoc o, or World Esperantist 
Physicians' Association. In serious literature, original novels, 
plays and other literature exist ; while many of the classical 
Greek, Latin, German, Polish, and other masterpieces have been 
translated into it. Among the translations may be mentioned 
the whole of \'irgirs ^neid (intj Esperanto verse), also some 
books of Homer's Iliad. Several of the plays of Shakespeare, 
Moliere, Schiller, and Goldsmith, some books of the Scriptures, 
Renan's "Life of Jesus," the Comnninist Manifesto of Marx; 
so that there is ample choice for people of every turn of mind. 

Finally, mention must be made of the fact that in Novem- 



jvGoo'^lc 



KENNETH W, MILUCAN, M. D. 81 

ber, 1908, Dr. Pierre Corret presented for the Doctorate of the 
Paris Faculty of Medicine a thesis advocating the use in medi- 
cine of Esperanto. It was called the Utility and Possibility of 
the Adoption of an Auxihary International Language in Medi- 
cine.* This thesis attracted the profoundest attention from his 
judges— men whose names are well known to you ; Professors 
Bouchard (president), Chantemesse, Renon, and Balthazard — 
with the result that it obtained the rarely granted commendation 
of "Very good." And further it has the unique experience of 
having converted its judges to Esperanto. I have to acknowl- 
edge thankfully frequent aid from it. The thesis ended with 
five conclusions, from which the following are extracted: 

"Esperanto being very easy of acquisition for all, and suited 
for treating of all medical subjects ; the experience of the Inter- 
national Esperantist Congresses having moreover demonstrated 
that it makes possible the immediate discussion of the most 
diverse subjects between congressisis of different tongues, in- 
capable of understanding one another in any of the national 
tongues, it is desirable that its use should become generalized 
more and more in the international medical congresses, and to 
that end, that it should henceforth always be admitted to the 
number of official languages of those congresses. 

"It is equally to be desired, and for the same reasons that 
authors of articles and medical works presenting general interest, 
should append to their works a resume in Esperanto, as was done 
notably by Dr. Lambert in his Zurich thesis on the Theory of 
Torsion of the Humerus, and as the Russian review, Chirurgia, 
will henceforth do." 

These conclusions were officially subscribed to by the presi- 
dent, Professor Bouchard ; the dean of the Faculty of Medicine, 
Professor Landouzy; and the vice-rector of the Paris Academy, 
Professor Liard. 

HOW CAN ESPERANTO HELP PHYSICIANS? 

In the first place, by helping to advance the progress of 
medicine. This it can do (a) through making the congresses 
more profitable, by promoting general understanding of all papers 



*Utiiite et possibilite de I'adoption d'une langue interna- 
tionale auxiliare en Medecine: Paris, Presa Esperantista Societo, 
33 Rue Lacepede, 1908. Prix 2 fr. 50. 



)vGoo<^lc 



82 ESPERANTO IX MEDICINE, 

and discussions: (b) through making all literature accessible 
to all phjsicians; and (c) through promoting the interrelations 
of physicians of divers nationalities 

(ffl) What is the present condition of things as regards 
international medical congresses? Writing on this tc^ic, the 
British Medical Journal of February 8, 1902, said: "There can 
be no doubt that the linguistic difficulty, which began at the 
Tower of Babel, is a most serious obstacle to the progress of 
science. "Later, in its issue for February 6, 1904, it said: 
"At each of the three or four last meetings of the International 
Medical Congresses the confusion of tongues has made serious 
discussion difficult, and in some cases has reduced the proceedings 
to an unedifying farce. , . . The curse of Babel is on the 
International Medical Congress, and must inevitably bring it to 
ruin, unless means can be found of preventing its being treated 
by the natives of the country in which it happens to be held, as 
their own particular preserver." 

Indeed, an International Medical Congress has been face- 
tiously described as "a ceremony at which individuals of various 
nationalities gather without understanding one another, to pur- 
chase by their presence ihe right of having their communica- 
tions figure in the Transactions, and to take part "on the side" 
in certain fetes and excursions at a reduced price." 

Think, then, what a boon it would be, if there could be a 
common language which everyone could understand, even though 
he could not perhaps speak it fluently. Nowhere more than at 
medical meetings is it often true that "understanding is of more 
value than many words." I don't know whether that is in the 
Bible, but if it isn't it ought to be. 

What has been said applies in a lesser degree, but even 
more universally, to medical literature. Even a highly educated 
physician rarely reads more than three languages. Think what 
a simplification would take place, if every original communica- 
tion were accompanied by an author's resume in Esperanto. This 
plan has already been adopted by the Russian journal Chirurgia. 
No (vaste of time and money over translating, possibly resulting 
in an entire misapprehension of the author's meaning, but the 
author's main points fresh and hot from his own pen, in a 
language understood by all. Already, too, there is quite a 
literature of original Esperanto articles on medical subjects. 



)vGoo'^lc 



KENNETH W. MILUCAN, M. D. 83 

Corret, in his thesis already referred to, gives a list of 258 titles. 

Finally, consider the enormons advantage of feeling that 
you can communicate — as I am weakly doing — with any physician 
in any part of the world ; with the author of that Japanese article, 
for instance, in which you are so greatly interested; with the 
physician to this Spa or that heath resort abroad, to which you 
are sending one of your best patients; not to mention the social 
acquaintances that such a correspondence opens up. 

There is another aspect, also, to this side of the question 
Not more than a few weeks ago there appeared an editorial in 
the British Medical Journal, suggesting the great advantage that 
would accrue from an international inquiry into the ethical code 
Oil some matter, I forget what. That very course is an ac- 
complished fact among Esperantists. For 12 months the Voco 
de Kuracistoj has been conducting an international inquiry into 
the status of the professional secret, from the standpoint of the 
public, the profession, and the law. in various countries. 

I have already referred to the great advantage such a lan- 
guage would confer in time of war or of dire catastrophe, in 
which, in these days of internationalism, all the world runs out 
to help. In his book, Espvranto et Croix-Rouge, Lieut. Bayol, 
instructor at the military school of St. Cyr, France, gives many 
specific instances of the misunderstandings that occurred during 
the Boxer troubles in China, from which I select the following, 
not because it is the most convincing, but because it is the shortest : 
"At this moment an American officer, having misunderstood a 
verbal report that a French officer had transmitted to him from 
a Japanese general, supposed the affair finished, and so reported 
to his commanding officer. The Americans advanced immediately 
into the open to the east of the city and suffered great losses." 
This is not a medical incident, it is true; but who can doubt that 
similar unfortunate contretemps occurred in medical matters 
in that same campaign. 

It is true that this language would have to be generally 
learned in alt countries, to afford that relief to the present con- 
ditions that necessity demands. Well, there is no reason why 
the vast majority should not learn h; why, by teaching it, as 
recommended by the Pan-American Scientific Congress, in all 
primary schools, it should not become as familiar as English, 
French, etc., to the rising generation. We have already an 



)vGoo'^lc 



84 ESPERANTO IN MEDICINE. 

international system of weights and measures, of musical nota- 
tion, of telegraphy, of electrical units, of marine signalling — all 
"artificial." Why should the most useful international convention 
of all, an international language, be overlooked, or brushed aside 
as impracticable? As I have endeavored to show, it is sim- 
plicity itself. Let nie give you my own personal experience, I 
did not take it up voluntarily. As many, perhaps, of you know, 
I have always been something of a classicist, advocating stren- 
uously the restoration of Latin as an international language of 
science. But one day there drifted into the office of the journal 
on which I was engaged a communication in a language not 
recognizable as any one of the ordinary European languages, 
and it fell to my lot to struggle with it. I judged it to be Es- 
peranto, of which I had heard, and as it was evidently intended 
for publication, I forthwith spent a few cents on the necessary 
books and began to study them on the car going home. I have 
never regretted anything less in my life. Within the next 24 
hours a translation of the communication was in the printer's 
hands. In three weeks I was reading aloud in English an 
Esperanto novel written by a Frenchman, and within three months 
I had mailed to the editor of an Esperanto medical journal, pub- 
Hshed in Lwow, Austria, (the Voco de Kuracistoj, now the of- 
ficial organ of the World Esperaiitist Physicians' Association), 
an article on the professional Secret in the United States, as part 
of the international discussion on the subject above referred to. 
A copy of the journal containing this article is submitted. And 
I used no time to study, properiy so-called— except the novel 
reading which I did for sheer amusement — save that going to 
and fro between my residence and the office. Now, I confidently 
ask, is there any linguist here who, with all his linguistic at- 
tainments, will undertake to do the like with any existing natural 
language ? 

There is another advantage in Esperanto, which, however, 
as this paper is already too long, I will not attempt to prove or 
illustrate, but will content myself with merefy stating: that is, 
that a knowledge of Esperanto materially aids in the acquisition 
of an Indo-European tongue, for two reasons: First, it eluci- 
dates all grammar and idiom, reducing them from an artificial 
position to a logical scheme; and secondly, it aids in the acquisi- 
tion of a cosmopohtan vocabulary; for of the 2,446 original root 



)vGoo'^lc 



KENXETH W. MILLICAN, M. D. 85 

words,, the average English-speaking person is already familiar 
with 83 per cent; 64 per cent of these words occur in Latin; 
88 per cent in French ; 85 per cent in Italian ; 82 per cent in 
Spanish ; 81 per cent in" Portuguese ; 76 per cent in German ; 
and 42 per cent in Russian. Minor languages, so far as they 
are not affiliated with the Latin stock, are proportionately rep- 
resented. 

INTERCOURSE WITH AN INTERNATIONAL CLIEN- 
TELE. 
Finally, not to refer again to the subject of warfare and 
catastrophes, is there any country in the world where a much 
greater rnixture of races can be found, particularly among the 
lower classes, than in the United States? Surely, the use of a 
common language here would be of inestimable advantage to a 
mutual understanding between physician and patient. Do not 
be in a hurry to laugli at this as a reducHo ad absurdum of the 
whole question. You may, perhaps, think that at least the 
benefits of such a common language, if it were ever estabHshed, 
would necessarily be confined to those with a fairly good educa- 
tion. Setting aside the argument that, as Esperanto becomes 
more appreciated, it will be taught in the common schools of 
every country as an auxiliary language to the mother tongue, 
you would be wrong in your surmise for Esperanto can be 
learned, is being learned, to-day, by even very illiterate people. 
Not long ago, an acquaintance of mine, not an Esperantist, who 
had just returned from a large mining camp, told me that the 
thing that most impressed him was the fact that, owing to the 
great mixture of nationalities among the employees, who could 
understand neither one another nor their foremen — being Italians, 
Russians, Hungarians, Greeks, Scandinavians and Germans — 
most of them were learning Esperanto under the direction of the 
foremen, as a means of mutual understanding. Will you tell 
me that the great body of members of a learned profession can- 
not do what uneducated and almost illiterate miners are now 
doing, in the matter of intellectual accomplishment? 

'International Language, Past, Present and Future, By W. 
A. Clark, M.A., Oxon., Ph.D. Leipzig, London, J. M. Dent 
& Co., 1907. 

^Corret, These de Paris. 



jvGoo'^lc 



86 ESPERANTO IN MEDICINE. 

DISCUSSION ON Dk. MILLICAN'S PAPER. 

A. S. Burdick—Oar journa! is the only one in the United States 
which has, so far, given any attention to Esperanto. Some months ago we 
read an article in a western jourral, and in commenting, asked if our read- 
ers would like to receive lessons in Esperanto. We were surprised to re- 
ceive over 100 letters all urging us to print lessons. We have given some 
brief lessons. There have been two and this month we conclude the 
grammar, and following that we shall have some articles. 

The language is very simple and you can learn it all in a couple of 
hours. All nouns end in O for the masculine and A for the feminine. 
Opposite words are formed by the use of mal, therefore with a very few 
root words you can soon establish a fair working vocabulary. 

One beauty of the language is that one who knows a little of it can 
communicate with one who does not. Now that sounds strange, but it is 
so. There are little keys easily procurable in any language you wish. You 
can communicate wich a friend in any language, writing your letter in 
Esperanto and enclosing one of the little keys and with an hour or two oi 
work he can read your letter. It is not any more adaptable to one langui,ge 
than to another. Dr. Millican has sent some copies of a little booklet in 
which he is muih interested and I will leave them on the table. I hope you 
will take them and look them over. 

Wm. Porter — I 1>elieve Dr. Millican has arrived at his conclusion 
from experience. I confess I do not know much of the language. I have 
confined myself to what I have found in Dr. Taylor's journal. 

C. H. Hughes — I had a little experience in Esperanto in Holland year 
before last. Both clerks at the hotel where I stopped got so immersed in 
this that one of them added $1.00 on my bill and then undertook to convince 
me that it was all right. The great difficulty with Esperanto is pronuncia- 
tion. I have noticed that gentlemen trying to converse don't get along 
very well. It is very easy to say, change fratro to fratrino, but what's the 
use. A composite language, made up of the familiar wordj we are all 
accustomed to would be much better. Esperanto, to be sure, is the best 
attempt yet at a universal language, but what's the use? We have 
languages enough now without adding more. 



WHAT IS THE FUTURE?* 
By Dr. W. C. Abbott, Chicago. 
American Journal of Clinical Medicine. 

In the light of the present, being taught by the past, what 
has the future in store for our journals ? 

For many, death! 

This is blunt and harsh in expression, but for many it is in- 
evitable. What is to become of the purely personal journal? Dr. 
Love's was referred to this afternoon, "Love's Mirror," an able 



j.Lj.oo'^Ic 



ly. C. ABBOTT, M. D. 87 

publication in its day, presenting a delightful personality, passed 
in its usefulness and activity with him. So also must pass prac- 
tically every other personal publication unless the personality be 
of sufficient strength and sufficient perspicuity to gather around 
him in his declining years other younger personahties which he 
can imbue with the strength of himself, adding to his journal the 
best of their personalities. Let us hope that the majority of the 
journals represented in 'this association are of the growing char- 
acter, for either death will come from evolution, or life unques- 
tionably so. 

I say that death must come to many of our existing journals. 
Some 200 of them appeal for recognition and support, striving 
to do their part as opportunity is given them in the uplift of the 
medical profession, demanding of it recognition and its modicum 
of support, also recognition from the advertiser, from the purely 
and truly commercial field, book-publishing field and all that 
which goes to make the sum-total of the so-called (although 
wrongly and yet what shall we call it?) independent journal. We 
are hard to class. Some have tried to class us as "sheep and 
goats," take your choice. We are all striving to do the best we 
can. If we are ,'io-called independent publishers let us see that 
we let no one lead us. Let us stand together, moving forward 
into the field which is rightly ours and which we may have in the 
measure that we deserve. I welcome the organization press, as 
Dr. Taylor has so beautifully put it, evidencing that he has a 
better grasp of the situation than have many of its promotors. 
He has discussed it thoughtfully and kindly, but unfortunately the 
general press has not been fairly treated by the organization 
journals. This is passing away. Some editors have treated the en- 
tire medical pubhshing field in a manly, generous way. I cite as 
an example, the journal of the State of New Jersey. From the 
beginning to the end Dr. English, who has been in medical 
journalism for years, has refused to treat the medical press of 
America in anything but a manly, generous way. There are 
others. The number of organization journals that appear to think 
their function is to treat the general field lightly and contemptu- 
ously is lessening and will in time pass away ; meanwhile we have 
nothing but the kindliest of feeling for them. 

We have a great field, a work big enough for any men and 
broad enough for alt who are in it ; so, live and let hve, and yield 



;c=b,Goo<^lc 



88 WHAT IS THE FUTURE t 

the palm to no man in doing the square thing by the profession. 

It is everywhere admitted today that no class of professional 
men do as much work for a dollar or less than a dollar than the 
members of the medical profession. The Doctor is in and out in 
times of sickness and death and pec^le don't think it matters much 
whether they pay him or not. Where is there a man who gives 
his life to his work, who gives harder work for as little return as 
does the generous editor of the general -medical press? 

I say that death must come to many. The intensity of com- 
petition alone will not bring this about ; the grip of an intellectual 
octopus which seeks to control the minds of men is upon the weak, 
and in this battle between the opposing forces of individualism and 
absolutism, the weak of both parties will go down. The net of 
postoffice restriction will eventually gather in those who, perforce, 
stray too far from the shoie. 

Myself, with some members of the busy .staff of the American 
Journal of Clinical Medicine, are members of the National Adver- 
tisers Association that has its branch-clubs in all our cities, and I 
want to say that right here we get our finger on the pulse of what 
is to come. You all know of the arduous restrictions that have 
been placed upon the medical press in the last two years. All this 
is unquestionably prearranged in the interests of the great general 
Journals, regardless of their weaker brothers. These dominate 
in every great legislative measure which determines policies and 
regulates the laying of the lines between which we are all sup- 
posed soon to travel. 

Before these regulations come into being everything is ar- 
ranged right for the promoters of these regulations. The weekly 
journal, the weekly press in general, is all very kindly omitted 
from any especially onerous restrictions. They may keep their 
subscribers one year, during which time they may discuss with 
them the subject of whether or not they are to continue their sub- 
scription. In some parts of this country that is not considered an 
unreasonable time of credit. 

We have felt, in the monthly medical press, that as long as we 
were paying our own money we had a right to conduct our 
journals along business lines as we saw fit in justice to ourselves ; 
but the time has passed when we may exercise our own business 
judgment in these matters. We are now given four months only 
in which we may discuss with a delinquent subscriber whether or 



)vGoo'^lc 



fV. C. ABBOTT, M. D. S9 

not he cares to renew. If he is away from home, or there is 
some other reason why our correspondence is not attended to, we 
are obliged to cut hiln off just the same. I am not saying this in 
criticism, but I am merely saying that it may be considered ob- 
jectionable by those of us who have been in the habit of allowing 
our subscribers to run along on credit for a time if it seemed 
necessary for thein to do so. 

Some years ago when this measure was discussed in the 
Advertisers Association, Clinical Medicine got ready for it. It 
seems that the field in general don't get as much criticism as the 
American Journal of Clinical Medicine, and quite to the surprise 
of the spotters, they found us ready to meet them on their own 
platform and they went away wondering why they had come. I 
merely say this to show that it is no use to kick against these 
measures that come up. The only way to do is to clean up and 
get ready for them so that when they do come to investigate you 
they will find nothing amiss. 

At the Advertising Association at Kansas City last year, and 
in the presence of the Third Assistant Postmaster, there was in- 
troduced a resolution that upon the editorial page of every 
monthly, publication be published its net paid circulation for the 
previous month. The matter is to come up at the Louisville 
Meeting which will be. held in the early summer. Perhaps you 
want to do this. If so I am mighty glad of it. In any event 
it is likely that the resolution will be adopted and become a 
regulation of the P. O. Department. 

For many there will come from the evolution that is going on 
about us a new and stronger life: 

The very battle will strengthen them. Their limitations and 
faults will be made clear ; their purposes clarified ; their missions 
outhned. A journal, like a man, must have some kind of mission 
or motive to enthuse over and fight for if it or he is ever going 
to amount to much. Such a mission is developed under stress. In 
our work we of the American Journal of Clinical Medicine (col- 
lectively) feel that we have a mission to perform and are striving 
to teach therapeutics in advance of the general idea along the line 
of evolution in medical thought as we see and believe it. 

As independent journals we should think out our own 
thoughts, giving no man the right to say what we shall publish in 
our journals. 

Just a word in passing relative to specialization : I believe 



j.Lj.OO'^Ic 



90 WHAT IS THE FUTURE f 

that the journal which has not some characteristic peculiar to it- 
self is not doing; for its readers what it should and what they re- 
quire. In evidence of this I would call your attention to the vari- 
ous scientific bulletins that are springing up all about us. The 
general interest that is manifested in the special work which they 
are doing along special lines is evidence of the need for them and 
an index to the strength they will in time develop. It matters not 
so very much to what special line of teaching you are bending your 
effort so long as there is need for it and some reason for the ex- 
istence of your journal. The time has come when we must show 
some good reason for our existence or we will cease to be. 

What may come from the revolt that has broken out in the 
profession no man can tell. That there is a repressive tendency, 
which seeks to rule at any price, and which plans to dominate 
medicine in every material and intellectual phase, no man who 
reads the signs of the times aright can doubt. We stand for 
freedom, for the right of opinion of the mass as against those who 
urge the dependence 'of the many upon the alleged intellectual 
superiority of the few. In the name of Heaven isn't that a mis- 
sion big enough for the men of this Association? The question 
is what are we, you and I and all of ns, going to do about it? The 
immortal Nelson said : "When in doubt, fight." A very good and 
a very bad historical statement as it is handed down to us be- 
cause it omits to recc^ize the magnificent exercise of thought 
and judgment which lead Sir Nelson to his decision. The future 
is before us. Work is life, worry kills, so I would say, in the 
words of another: 

Cheer up old man! Be happy! Don't look so awful glum! 
Remember the good times you've had — there's better ones to come. 
Don't think because the clouds are black, it will forever rain, 
Hope on a little longer and you will see th^ sun again. 
This Hfe is all a mixture of happiness and pain, 
And joy will follow sorrow as sunshine follows rain, 
A spell of sickness makes a man appreciate good health; 
Reverses also teach us how to better value wealth. 
Then let us hear your voice again and see your old-time smile ; 
Just pull yourself together — go in and make a pile. 
Come ! Face the music like a man and throw the blues away ; 
You'll live to give advice yourself and laugh at this some dav. 

• EitsniporaQeous romorks. etenographlcoUy recorded. 



jnzosb.GoOi^lC 



WILLIAM PORTER, M. D. 91 

JOURNALISTIC CONFIDENCE. 

By William Porter. 
London Journal of Laryngology. 

There has been some mistake. I did not have any idea 
I was to speak to you in confidence. I have nothing to say 
to you but this : looking back over my own work I feel Aat 
all my editorial brothers are entitled to my fullest confidence en- 
titled to profit by whatever I may have gained in my battle with 
everyday affairs, but it is a confidence we may also share with the 
public. We profit by the works of others, so also should others 
profit by ours. 

A thought came to me while I appeared to be asleep back here. 
AH journals are not alike, neither can one fill another's place. This 
is the day of specialization and our journals are so wide in the 
fields they cover and each one so confined to its field that we are 
almost able toclassify them. In the days Dr. Marcy was speaking 
of one field would embrace them all. The American Medi- 
cal Association Journal with the state journals forms one 
link of the chain with which we are perhaps not so deeply 
concerned as we are with some others, but they are no doubt 
doing a wonderful work in organization. They are subject to 
criticism, but then so aVe we all. Outside of this we have the 
journals of general trend, of daily help to the general practitioner 
and in these, after all, is the most possibility for good and for 
earnest thought to make them really a source of help to the hard 
working doctor. Special journals, representing different phases 
of special work are also numerous and wonderful in themselves 
for their scientific teachings, and yet sometimes I feel that tliey 
are too complicated, we are lost in a maze of long technical 
terms which we don't half understand and so the real gist of the 
thing is lost. I wish that editors would exercise their privileges a 
little more in editing out that which is so very scientific that it is 
confusing. We are getting almost to a place where we read an 
article and about every second or third word we have to stop and 
look up and when we get through we wonder what it was all 
about anyway. 

The journals for the general practitioner should especially 
be as simple as possible. They are intended for the physician 
just as he is, to help him with his every day work. When he 



qiizoob/GoC^lc 



yg JOURNALISTIC COSFIDEXCE. 

comes home tired and just before going to bed picks up a journal 
h* may find in it something regarding a case similar to one which 
has puzzled him all day. If it is simply and plainly told it will 
be of intrinsic value to him and that journal will be a power in 
the country. 

In the matter of advertising : I confess I would not know how 
to conduct the advertising end of a journal. If a man came to me 
with something I was not sure of and I needed the money I am 
■jure I would be tempted to accept his ad If I turned it down I 
would always wonder if I had done right in turning it down or 
had thrown a wet blanket on some man's honest endeavor. So I 
have all syn^athy for the man who now and then takes in some- 
thing which is afterwards criticised. 

In the last class we have journals that are not dependent upon 
advertising or subscriptions, the official bulletins, a class coming 
mto exstence only a few years ago and fast making a place for 
themselves. There is the Johns Hopkins Bulletin, the various 
State Board Bulletins and the one with which I am directly con- 
nected. In this we may bring together medical information thor- 
oughly unprejudiced because entirely independent of advertiser or 
subscriber. We bring tc^ether the very best of the medical 
thought of the day along the line to which the Bulletin is devoted 
and send it out to the press who may use'it or not as they please. 
I take it that this class of journals, if they can be cared for as 
they should be will in time be one of the most valuable we have. 

So you see, in speaking in confidence of our various journals 
I have before me a very large subject and if I go on I am afraid 
I will do it more harm than I have already. 

THE RESPONSE -FROM THE READER. 
By William Wangh, M. D., Chicago, III. 
American Journal of Clinical Medicine. 
NE of the most difficult tasks of the medical journalist, 
next to paying the bills and yet holding up enough currency 
to attend the meeting of the American Medical Editors' 
Association, is eliciting such a response from the readers 
may enable him to judge of his own work. 

From some few we have responses a plenty. The kicker 
always with us. The man who thinks he has something to say 







jvGoo'^lc 



WiLUAM WAVGH, M. D. 93 

but hasn't, and is disgruntled that we do not print his stuff; the 
wrathful party who stops his subscription for reasons and more 
frequently supposititious reasons, sundry and manifold, are rep- 
resented with discouraging' frequency in our letter box. It 
is scarcely credible how many men will make personal a[q}lication 
of items not directed at them or at anybody in particular. I 
once quoted an item concerning a man who had lived seven 
months without a stamach ; and I added the comment : "That's 
nothing. I know lots of men who are living without bowels, and 
some of them owe this journal for subscription." The item was 
purely impersonal, and I really labored under the delusion that it 
was a joke ; but forty-seven doctors promptly forwarded their 
delinquent subscriptions and every last one of them accompanied 
the remittance with a furious letter, lambasting me for having 
thus publicly roasted him, I have been ever since trying to 
think of another similar item, but somehow my clever ideas do 
not seem to be intentional. 

But ^art from these undesirable correspondents, the vast 
mass of our readers seem to be deaf, dumb and blind. They 
may possibly appreciate the scintillations of coruscating wit that 
bum holes in our pages, and sometimes dislocate letters, words 
and even entire lines, which we naturally blame on the printer; 
but so far as any direct means of judging go, we are preaching 
to dead walls. 

The only means we have of judging the effect of our work 
is by the subscription list. Unfortunately this is an afterthought, 
an autopsy ralher than a prognosis ; and recalls the nurse's esti- 
mation of the baby's bath — if it turns baby blite it's too cold, if 
red it's too hot. The best we can do is to guess what will please 
our readers, and on our guessing ability depends our success. 

Two efforts at getting in touch with readers deserve atten- 
tion: The New York Medical Journal runs a series of prize 
essays on practical topics. The Medical Standard has a round 
table, where contributors air their views. The two represent rad- 
ically different methods: Dr. Foster selects the essays he ap- 
proves, and as he rejected my own I consider his judgment very 
bad. But good or bad it represents Foster and his personal views ; 
whereas Atkinson throws open the lists for any who chooses to 
break a lance. Our- preference will accord with our belief in 



)vGoo'^lc 



94 THE RESPONSE PROM THE READER. 

centric domination or in democratic equality ; in orthodoxy or in 
free speech, 

A study of the situation for many years convinces me that 
the reader is primarily and entirely concerned in himself, and 
what interests him most is his own interests. . The editor who 
stands nearest the average doctor will reach the average doctor. 
The journal that gives most real aid to the practician is the jour- 
nal he willingly buys. The editor's tendency is to grow out of and 
away from his class, and up toward those lonely hights whereon 
sojourn those chosen few who never read anything so evanescent 
as periodic literature. We tire of common things and rehsh the 
new, the unusual; so that in time our ideal is the case that never 
was heard of before and never will be again. But the man who 
is treating interesting patients with acute diseases, and profitable 
ones with chronic ailments who must be kept alive and on the 
pay list, has no time for museum curiosities. 

Some years ago I undertook to improve the journal. I care- 
fully excluded all but strictly scientific papers, by "high-up" men, 
cultivated the abstruse, suppressed every trace of commercialism, 
elided everything that savored of slang, and in every way "im- 
proved" the journal and raised its standard. Compliments came 
in, but the subscriptions fell off. I took a vacation, and the tripod 
was mounted by a vigorous personality, a man who thought 
straight, and talked slang — that graphic form of expression that 
indicates thought-development so energetic that it outgrows its 
orthographic clothes before they are worn out. He printed 
very commonplace matter, written by every-day doctors, about 
every-day things ; and let in commercialism in a flood, 

I groaned over every copy, and returned to find the subscrip- 
tion list booming frightfully. 

I concluded that the subscriber was only interested in him- 
self, and wanted first and last what he could use in his business. 
Apart from this he is attracted by the editor's personality; and 
here is a point : Sydney Smith once said it was useless for any- 
body to try to appear as aught but what he was; the world is 
clear-sighted and quickly detects pretense, which is in itself con- 
demnatory. Whereas if a man is simply his natural self he may 
feel easy that those who approve him do so because they like the 
real him and not something he pretends to- be but is not. The 
journal through whose pages its editor's true personality does 



)vGoo'^lc 



WILLIAM WAUGH, M. D. 95 

not show is but a lifeless thing, and like other dead things, should 
be decently buried. 

DISCUSSION ON DR. WAUCH'S PAPER. 
Geo, F, BHiler — I believe that personality has more to do with the 
success of a journal than anything else. Dr. Hughes' journal is a verj 
good instance of this. I hope after the Doctor passes away someone will 
be able to carry on his interest in the journal which I read from cover to 
cover each month, but if no one is found to carry on the work after him, it 
is some satisfaction to a man to know that he has made his journal a suc- 
cess because of his own personality. 



ORGANIZATION MEDICAL JOURNALISM. 
THE TREND IN MEDICAL JOURNALISM. 

By C. F. Taylor, M.D. 

EDITOR OF THE "MEDICAL WORLD," PHILADELPHIA. 

PRESIDEN'T CROTHERS askt me to join in a symposium 
on independent medical journalism, suggesting that I 
write on "The Advantages of Independent and Personal 
Responsibility in the Conduct of a Journal." I immedi- 
ately recognized this as being the most desirable part of such a 
symposium, but I wrote him that in our Association there was 
no need to praise independent medical journalism. And that if I 
presented anything, I preferred that it be on Organization Medical 
Journalism. There are two chief reasons why I choose this topic : 
First, because I am deeply interested in the subject, and have given 
organization journals careful study ; second, I though it not proba- 
ble that anyone else would choose this subject for this meeting. 
I wish also to announce at the outset that I will treat this subject 
sympathetically; any criticisms made will be incidenial and in- 
tended to be helpful, rather than disparaging. 

The chief organization medical journal in this country, the 
Journal of the A.M. A., is not a new, nor is it any longer a young 
journal. It did not attract any special attention until the AM.A. 
began to take up vigorously the problems of the profession, as in 
regard to medical colleges and medical education, medical legis- 
lation, medicinal preparations offered to the profession, etc. These 
entirely legitimate and too-long-deferred activities of the A.M.A. 
have been naturally and appropriately reported in the oi^n of the 



jvGoO'^lc 



»G ORCASIZATIOS MEDICAL JOURNALISM. 

Association, and these are among the reasons for the phenomenal 
growth in the circulation of that publication during- recent years. 
Another ver>' powerful reason is the great amount of money and 
energy put into the promotion of oi^anization, by extensive solicit- 
ation by paid agents for new members of county associations and 
state associations, these being the portals of entrance into the 
Xational Association, the expense being divided among the asso- 
ciations and publications thus benefitted. This is entirely legiti- 
mate and proper ; but it naturally works a hardship to the inde- 
pendent periodicals which cannot compete with such methods. 
For example, if any of us could make such a powerful appeal as 
that just described, paying only a portion of the expense, the ad- 
vantage to our circulations would be very great. On the other 
hand, we must appeal single-handed to the doctor, and the support 
which we win from him must be won by merit only, without the 
addition of the advantages and privileges of organization member- 
ship thrown in as an extra inducement. With the above-men- 
tioned advantages, and with the above-mentioned and numerous 
other important functions to perform, it is but natural and fitting 
that the organ of the greatest medical association in the world 
should become the greatest medical periodical in the world. 

As a member of the A.M. A. for many years, I am proud of 
its great organ, the Journal of the A.M. A. But I am ashamed 
of its efforts to cripple independent medical journalism. Its hos- 
tility to medical journalism other than organization medical jour- 
nalism has been exhibited tn many and various ways, times with- 
out number. For example (exhibit) : 

[Here were exhibited announcements of coming meetings of medical 
associations, clipped from the pages of recent issues of the Journal of the 
American Medical Association, in one list there being 35 such announce- 
ments, Imt in no list was there any announcement of the present meeting 
of the American Medical Editors' Association.] 

I do not remember to have ever seen a mention of any kind of 
the meetings or transactions of the American Medical Editors' 
Association or of any paper read before it, in the columns of the 
Journal of the .^.M.A. during its present management. However, 
I am inclined to regard this as a temporary imperfection of the 
organ of our great National Medical Association, and I fee! cer- 
tain that a broader and more liberal policy of that publication in 
the future will correct that imperfection. 



)vGoo'^lc 



C. F. TAYLOR, M. D. 97 

The most notable development in medical journalism in recent 
years has been the rise of state organization journals, most of 
them monthly, taking the place of the annual bound volume of 
transactions. About 20 states have made this change, which seems 
to be generally satisfactory to the membership of said associa- 
tions. There are many ways in which a monthly organ can serve 
the interests of a state-wide association not possible to an annual 
publication. In addition to the papers read before the association, 
distributed thruout the year, news can be gathered from the com- 
ponent county associations and published monthly, the work of 
numerous committees can be reported frequently, medical defense 
can be promoted by means of editorials, etc., provisional programs 
of future meetings can be publisht preparatory to perfecting the 
final program, medical legislation, public hygiene, etc., can be pro- 
moted, and many other appropriate and useful functions can be 
and are performed by state medical organization periodicals. 
What local private journals formerly did voluntarily, the organ- 
ization journals now do officially. Certainly the profession of a 
community, a state, or a nation, has a right to conduct a publica- 
tion for itself, thru and by its appropriate officials, if the organized 
body so desires. And thus a great national medical journal and 
about 20 state medical journals have arisen in this country, the 
national journal being now about a quarter of a century old, and 
the state journals having arisen in about the last five years, a few 
being a little older than five years, and several considerably 
younger than five years. 

On the whole, I consider that official medical journalism in 
this country has been and is eminently successful. The official 
journal is now considered the life of the association, national 
and state — this remark of course applying to those state associa- 
tions that have a journal. In one or two cases, two or more con- 
tiguous states in which doctors are not numerous have combined 
in the support of a journal. I can see how this process of com- 
bination may be extended to the mutual advantage of all con- 
cerned. I am convinced that official medical journalism has come 
to stay, and that it will improve as the years pass by. Indeed, it 
should improve, considering its assured and increasmg support. 

While official medical journalism has many features of per- 
manence and inherent strength, it has some inherent elements of 
weakness. The fact that the primal purpose of such a journal 



)vGoo'^lc 



98 ORGANISATION MEDICAL JOURNAUSM. 

is to serve and promote the interests of the organization of which 
it is the chief means of expression, is at once its greatest strength 
and its Hmilation, While the independent journal has not the 
devoted support of an organization, yet it is not limited to any 
association in seeking its support, nor is its service limited to that 
of any organization. 

The editors of organization journals are subject to frequent 
change. A case in point is the following: The editor of Jour, of 
the S. C. Med. Assn. has just retired, and the journal not only 
goes into the hands of a new editor, but the publication office of 
the journal will be removed from Greenville to Florence, S. C, 
The retiring editor says (page 204, May issue — Italics ours) : 

It has at no time been our intention to make a life work of medical 
journalism, and many times since assuming the editorial pen we have 
been sorely tempted to lay it down ; but each time that the decision to 
do so had almost been reached, circumstances involving duty to the 
profession, to our friends and to our ovm professional pride, have turned 
up to prevent. 

This means volumes to the "seasoned" medical editor. In these 
days of specialization, no one can expect to be successful in a 
vocation unless he is willing to make it a life work. This uncer- 
tain tenure with possibility of frequent change in editorship will 
always be a weakness of organization medical journalism. It 
prevents the occupant of the editorial chair from making a life 
work of his vocation, and this compels him, as a rule, to continue 
in the active practise of medicine, making his editorial work sec- 
ondary and subordinate. On the other hand, the independent 
medical journalist can, and the best of them do, make a life work 
of their vocation, with the results that usually come from con- 
tinuous devotion to a chosen calling. 

Another radical difference between official and independent 
journals is suggested by the remark quoted from President 
Crothers in the first part of this paper ; i.e., the advantages of 
independent and personal responsibility in the conduct of a jour- 
nal. The editor of an official journal must always be under the 
control of his superior officers, and subject to the prevailing sen- 
timent in the organization, and subject to possible dismissal The 
writer is certain that his efficiency as an editor would be seriously 
curtailed if he had to submit every matter of policy to a publica- 
tion board. Perhaps it will be admitted that the writer has had 
unusual experiences in radical departures from the long-establish t 



)vGoo'^lc 



C. F. TAYLOR. M. D. 99 

rules and customs in medical journalism. He is certain that he 
could never have done these things if he had been subject to the 
control of a board or committee Many of these departures were 
vigorously opposed by many subscribers at first, but the writer, 
being convinced that he was right, continued his course amid 
losses of subscribers and finally won many of the lost ones back, 
together with many more new ones from various sources. It is 
at once evident that an organization editor could not do such a 
thing. And it is just such things that broaden the scope of medi- 
cal journalism. 

It is regretted that when the usually green and inexperienced 
official medical editor appeared on the scene the egotism and 
assumption usual under such circumstances came disagreeably 
to the surface, particularly in several instances. One of these 
special instances was the Jour, of the S. C. Assn.; but of this we 
will say nothing, as the offending editor has just retired, and we 
will hope for better from the new editor. These offending official 
journals assume all the virtues under the sun, and refer to the 
independent journals insultingly as "commercial" journals, "pub- 
lish t- for-profit medical ( ?) journals," etc. Chief in this intolerant 
and insulting attitude has been and still is the California State 
Jour, of Med.; and yet in this class of journals, particularly in 
the most offensive ones, there is more commercialism in the ed- 
itorial matter than in even the least reputable of the independent 
journals. In the last issue (May) of the California Journal, page 
l6o, is the following; 

It may be said, parenthetically, that business conditions are decidedly 
improving with the early months of the present year; already two pages 
of new advertisements have been received, and others are anticipated. 

This is only a mild example of the commercialism that has 
for years appeared in that very offensive journal. One of the 
youngest as well as one of the best of the official journals is the 
Jour, of the Ind. State Med. Assn.; but in the editorial depart- 
ment of that journal has the pitiful wail for advertising patronage 
been frequent and strong. Perhaps this may be partly accounted 
for by the editor having been previously engaged in private medi- 
cal journalism of the kind dependent almost entirely upon adver- 
tising for its support. This was admitted by him, but if I re- 
member correctly he said entirely instead of almost entirely. So 
the death of that kind of a private journal was regretted by no 



)vGoo'^lc 



100 ORGANIZATION MEDICAL JOURNALISM. 

one, and the editor evidently finds much greater pleasure in con- 
ducting an official journal, which is certainly ably conducted and 
is doing a useful work. And I am glad to say that in the last 
couple of issues of the Indiana Journal I have been unable to find 
any of the aforesaid wails for advertising patronage, and let us 
hope that they have disappeared permanently. 

The Kentucky Journal shows many marks of lack of dignity, 
and of experience In journalism ; at the same time it shows some 
ability, and remarkable devotion to the supposed interests of the 
society of whicli it is the organ. In so late an issue as that of 
April ist there are two editorial boasts of the obtaining of certain 
advertising contracts (pages 243 and 246), and on pages 297 and 
298 are given the details of a commercial contract that in a high 
class private journal would be confined to the business oflfice, or if 
publication were necessary would be put among the advertising 
pages. When experience ripens the editor of this journal there 
will be more dignity and less commercialism in the journal. 

This commercialism in the editorial pages appears sporadically 
in several (and possibly all) of the other state journals. Among 
these may be mentioned the Texas Journal; and, I regret to say, 
the N. J, Journal ; and also in the usually excellent, dignified and 
high-class Illinois and Ohio Journals. I hold in my hand exam- 
ples torn from recent issues of each of the above-mentioned jour- 
nals. 

A feature that the official journals seek to claim, and a feature 
that some of them seek to enforce upon all medical journals, is 
that no advertising of medicinal substances shall be admitted ex- 
cept preparations that bear the seal of approval of the Council of 
Chemistry and Pharmacy of the A.M. M. .After all that we have 
heard about this from the official journals, we see a statement on 
page 3 of the May. 1909, issue of the Texas Journal showing that 
less than half of the official journals have adopted that standard; 
and we frequently see suspicious advertisements in the journals 
claiming that standard. However, these local official journals 
have brought out a large amount of attractive and useful adver- 
tisements of local hospitals, sanitariums, health resorts, schools 
etc. They are to be congratulated upon the discovery and devel- 
opment of this new business which adoms their advertising pages. 

But little has been said, because I feel that little needs to be 
said before this Association, about the class of medical journals 



)vGoo'^lc 



C. F. TAYLOR, M. D. 101 

known as "independent" — that is, not depending upon an organ- 
ization for their existence. I have on a previous occasion given it 
as my opinion that the independent journals would become fewer 
and better. The state journals are particularly hard on the local 
independent journals. And now that the state journals are getting 
so numerous, they may be expected to cut down the circulation of 
the independent journals of general circulation excepting those 
devoted to a specialty. If I may be permitted to illustrate by an 
individual reference, I will say that for several years past I have 
been regarding the business side of my publication as in the nature 
of the situation a declining prospect. But I have been gratified 
each year by the figures failing to show a decline in returns ; and 
on inspecting a tabulated report which I caused to be gotten up 
as a basis of any statement to be here made, I find owr returns to 
have been advancing instead of declining in the time referred to, 
and that the year ending the 30th of last June was one of the 
largest, if not the largest, in our history; and particularly was it 
the largest mi subscription receipts in our history. With this 
showing we can feel sure that both independent and official jour- 
nalism can and will live in this great country. It is to be regretted 
that the official editors have organized themselves into an inde- 
pendent editorial association instead (with a few exceptions) of 
coming into the regular editorial association. But I an optimistic 
enuf to believe that in time the spirit of intolerance and opposi- 
tion exhibited by some of the "youngster" official editors will dis- 
appear with ripening experience, and that in time we will all be 
found "under the same umbrella." 

This report of my study of the official journals is cursory 
and incomplete ; but I trust that it is sufficient to give an idea of 
the trend in medical journalism. 



Note. — Proof of the above paper being submilted to me October 27, 
1909, gives me an opportunity to say that for a number of months pasf, 
including the issite for October, 1909, the California State Journal of 
Medicine has been pursuing a dignified course, having entirely discon- 
tinued its former offensive practices. We congratulate the profession of 
California upon this change, and we hope that it will he permanent. On 
the other hand, in the September issue of the Journal of the Indiana State 
Medical Association (pages 395 and 401), we find a resumption of the 
former editorial wails for advertising patronage. The broad trail of 
commercialism is also seen in the October 1st issue of the Kentucky 
Medical Journal, particularly on pages 810 and 811. Page 836 is devoted 
largely to an advocacy of the use of only those remedies that have re- 
ceived the approval of the Council on Pharmacy and Onemistry, and a 



),L_nOO'^IC 



102 THERAPEUTIC SCEPTICISM IN MEDICAL HIGH PLACES. 

condemnation of medical journals that advertise preparations that have 
not received the Council's approval. Yet in prominent positions in this 
issue are advertised two houses whose [ireparations have been reported 
on adversely by the Council — and other things might be said of the adver- 
tising contents of this issue. The precious jewel of consistency does not 
seem to have reached Kentucky.— C. F. T. 



THERAPEUTIC SCEPTICISM IN MEDICAL HIGH 
PLACES AND ITS POPULAR HARM. 

By C. H. Hughes, M.D., St Louis, Mo. 
Editor Alienist and Neurologist. 

IT is not uncommon for men of prominence m the profession 
to be lacking in faith in medication from want of that perfect 
experience and study of all the conditions which cause failure 
or success of therapeutic effort or from too great eagerness 
for hasty and so-called brilliant surgical results at the expense of 
the anatomy. 

The factors of neglectful observation and nursing and 
favored adverse environment and heredity, omitted removal of 
remediable sources of psychic depression in the patient, over- 
looked conditions and not rightly invoked of physical comfort, 
nutrition, etc., essential to recovery through mental satisfaction 
not secured, etc., are often at fault in the therapeutic agnostic. 
Too much is often expected of the medicine alone, without 
these essential aids to its salutary eflfect. 

The patient's local disorder is sometimes aimed at thera- 
peutically also by other than surgeons, but the patient himself 
is not treated in his general physical and psychical needs. The 
hygiene and sanitation of his mind is too often greatly over- 
looked. His psychotherapy is neglected and no suitable attention 
given to proper chertiico therapy and neuro-therapeutic and psy- 
cho-biologic, combined with the standard remedies. 

These omitted adjuncts to the best effects of medication 
often make the therapeutic sceptic who loudly proclaims that 
medicines do no good in disease. 

In the face of every demonstrable fact, such as the direct 
anodyne eifect of opium, the somnifacient effect of chloral and 
the other hypnotics and anaesthetics, the emetics, cathartics, 
sudorifics, etc., etc., etc., men decry the use of drugs because 
they have failed in their hands, with as much reason as they 



)vGoo'^lc 



C. H. HUGHES, M. D. 103 

might deny diaphoretic power when a draft stops the sweating, 
or diuretic power when tlie ureters are obstructed, or cathartic 
power because of intussusception or strangulated hernia. 

In face of the fact of the microscopically as well as clin- 
ically provable evidences that quinine paralysis and kills Plas- 
modium malaria and that mercury destroys the spirochaetas pal- 
lida of syphihs, to say nothing of the power of sulphur over 
itch and the other remedies for skin affections. 

Wild, unwise, wide-of-the-mark statements like these ar\ 
made by men of merit in many respects in medicine and misused 
by the promoters of the mind-healing Christian Science and the 
quack advertising faddist and dishonest misleaders of the people 
for monetary motive. 

Statements made in the course of a lecture and delivered 
with reference to a disease, like cancer, for instance, as quoted for 
advertising purposes in the public press and with the very dis- 
play we give it : 

"MEDICINES ARE POISONOUS 

In their zeal to do good, physicians have done much harm. 
They have hurried to the grave many who would have recovered 
if left to nature. All our curative agents are poisonous, and as a 
consequence every dose diminishes the patient's vitality. This 
was credited 'in a newspaper advertisement to Dr. Alonzo Clark, 
Professor in the New York College Physicians and Surgeons. 

But all medicines are not poisonous, many are purely recon- 
structive, restitutive and protective and reparative to the organ- 
ism, others are antiseptic, others increase the phagocytic power 
of the blood and others are eliminants of poisons, like the anti- 
septic cholagogue laxatives that cause indecan to disappear from 
the blood and urine. 

Now look at this taken from the body of an address by 
Osier and put into a display quack advertisement in a daily 
paper, thus showing that physicians cannot be too careful what 
they say and when and where smacking of therapeutic skeptic- 
ism. 

"THE BEST DOCTOR- 

No doctor can cure all diseases. That's all moonshine. They 
are 'pretenders ' If you can't cure a man tell him so. Physicians 
use too many drugs. I believe that the best doctor is the one 



jvGoo'^lc 



104 THERAPEUTIC SCEPTICISM IN MEDICAL HIGH PLACES. 

who knows the worthlessness of medicine." Attributed to Dr. 
Wni. Osier in an address to physiciSns. Abstracted from a 
quack advertisement in a daily paper of a cure without medicine. 

There is a good deal of moonshine in this statement of Osier, 
but he never intended it to be regarded as such, or to be displayed 
in a quack advertisement. 

Medicines are certainly not worthless, though it may be 
true that they are in the case referred to by Dr. Osier if relied 
upon for direct cure. But medicines that help to estabUsh im- 
paired functions are not worthless, even though they only pro- 
long life through improvement of physiological movement in 
vessels or viscera or systems of nutrition or normal metabolism. 

But the last two paragraphs are not true. Some physicians 
use too many, others not enough drugs, and the best is not the 
one who regards drugs as worthless. The best doctor is he who 
makes a cautious safe diagnosis and with full faith and thera- 
peutic experience places the right drug in the right place at the 
right time to promote a cure and who takes due account of the 
fact that the patient is a mentally as well as physically governed 
individual as Forbes Winslow did as far back as in the middle 
past century.* 

To thus in general terms to decry the value of medicine in 
disease is to a.ssault the foundations of cure upon which the 
fabric of our profession rests. Why continue to exist as a 
profession if we have no therapeutic resources? 

The carping denouncer of our therapeutic resources does 
not dare 1o say oxygen is no good for the relief of dyspnoe, iron 
for anasmia, antitoxic serums for the poison imperilled, predi- 
gested foods for the dyspeptic, mercury for the venereal, or 
quinia for the malaria. 

Yet there are surgeons of note who say 'only quinia, mercury 
and opium are reliable, omitting to note that their constant use 
of anodynes other than opium are in constant use by them. If 
medicine can produce emesis and cathisis anesthesia and obtund 
pain, what may not other agencies do, and they do accomplish 
great results before the minds of those who diligently observe 
without bias of agnosticism. 

Do not the antitoxines to a certainy excite the anti-bodies 
of the bloo<l to remarkable resistive action against disease? Has 
not Jenner's vaccinia transformed the virulence of variola into 



jvGoo'^lc 



C. H. HUGHES, M. D. 105 

varioloid aborting and more often preventing, and now having 
almost obliterated one of the most virulent scourges of mankind? 

And what of Flexner's lymph for meningitis. Is not the 
ductless glands now doing a wonderful therapy. 

These men and women give excuse for Christian Scientist, 
who though he goes to the dentist for dental remedy and to the 
surgeon to set a broken limb and lets in the butcher and baker, 
etc., to satisfy his bodily wants and screens out those carriers of 
disease, the mosquitoes and flies, yet proclaims the non-existence 
of the diseases the mosquitoes and flies and fleas breed. The 
medical therapeutic Nihihst and the Christian Science healer 
stand on the same illogical plane invoking and proclaiming the 
singular sophistry of doubt. 

He seems to know little of the angiostenoses, angiospas- 
moses, angiostetectoses under electrizations and internal remedies 
effecting the vaso motor and vaso-dilator systems or of the trea't- 
ment of disease by act i no-therapy and X-ray or Finsen ray. 

Most surgeons accept the X-ray now for aid in diagnoses, 
because it keeps them to see better where and what to cut out. 
They would cure by abridging the anatomy by the knife, and 
yet the same agency that helps them to see where to cut can 
also destroy tumor growth. It is always preferable to cure. 
where practicable, through re-establishment of physiological 
movement, molicular organic or aystemic, rather than by de- 
stroying any part of the normal anatomy and this is seldom and 
never best accomplished by the knife. We should preach the 
doctrine of physical salvation wherever we can, even though 
we have to employ drugs to accomplish the saving. It is not 
good for the progress of medicine to sit in the seat of the 
scornful of every thing therapeutic but the knife, ligature or 
cautery. 



)vGoo'^lc 



10« JOURNALISTIC INSIGHT. 

JOURNALISTIC INSIGHT. 
M. M. S. Johnstone, M. D., Chicago, HI. 

IN order to be successful as a journalist, one must have two 
gifts. The first, call it "second sight" if you will, is the 
power which enables one to see ahead, and to know what business 
methods will keep the journal 'on a good financial basis, what 
material will be of interest and of value to the readers of the 
Journal, and to choose capable assistants for the staff of editors 
and collaborators. The second requisite is a personality which 
unconsciously attracts and rules others. 

Would that the business side of this question could be left out, 
but in order for a journal to live, it must be able at least to meet 
its expenses. 

The expenses must be met by the constituents' fees and the 
advertisements. 

First, one must choose one's constituents. Is it the internist? 
the surgeon? the ophthalmologist? or, whom shall the Journalist 
serve? If there is an empty corner in the medical literary field, 
there is the journalist's opportunity, which requires keen insight 
to see and profitably appropriate. 

The next point is, to compile a paper that shall meet the 
needs of the readers. 

But this subject will be discussed later. Then the journal 
must be brought to the notice of the should-be constituents, and 
in such a way that they will be favorably impressed by it and 
persuaded that they must add it to their list of journals. 

This must be done partly by sample copies, partly by the per- 
suasion of carefully selected persons who understand human na- 
ture well enough to make the victims wish to subscribe. 

Surely one nftist have journalistic insight in order to carry 
on the business side of the journal. 
" Lastly come the advertisements. Of course, they must be 
ethical, but here, again, foresight is necessary. The editor must 
not only collect advertisements that will pay, but such as will be 
of value to his constituents. 

The next question to be considered is that of subject matter. 

Manuscript must be judged, not only from the points of 
view of grammar, rhetoric, and truth according to present knowl- 
edge, but the following questions must also be regarded : Is the 



jvGoo'^lc 



M. M. S. JOHXSTOXE, M. D. 107 

article of value to the constituents? Is the style such as to make 
it interesting? and, if some new phase of a question is presented, 
is it an addition to the truth ? 

Next, the journalist must know and consider his contempo- 
raries and their work. With whom must he compete? What 
are the strong points? What the weak points in their journals? 
Wherein do the others fail to interest, or meet the needs of their 
readers ? 

-Here, again, journalistic insight is of value to the editor, both 
in solving these problems and in putting the knowledge thus 
gained to practical use ; for the editor must not only emulate the 
good points in the works of his contemporaries, but he must make 
his own journal strong where the others fail. 

The collaborators remain to be considered. Indeed the suc- 
cess of a journal depends largely on the editorial staff. One 
must be able to pick out from the many writers such as are able 
and willing to do journalistic work, to assign each to the right 
place, and to choose persons who can be depended upon, persons 
who will have the required articles, as editorials, abstracts, or 
reviews ready in time, and who can when necessary, prepare mate- 
rial to help iill in the journal. 

Finally, such must be the personality of the editor-in-chief, 
and such his relations to his staff, that they work together in per- 
fect harmony. Frictions spoils the work of any machine. In 
journalistic work, the editor-in-chief must be able to depend on the 
hearty co-operation of the rest of the staff, and they, in turn, must 
respect, and willingly further the plans of the editor and the 
best interests of the journal, yet the editorial staff, working to- 
gether as a whole, must not sacrifice the independent thought of 
any one member of the staff. 

Journalistic insight is not necessarily intuition, nor does it 
find a field of action in job printing and publishing work. 

Journahstic insight is that intellectual capacity which enables 
one to read the future from a knowledge of the past; to know 
that such being the conditions, what result must inevitably follow ; 
and to judge candidly the character and ability of the people with 
whom one comes in contact. 

Journalistic insight, in other words, is the well- developed 
judgment which is founded on a broad icnowledge and a wide 
experience. 



jvGoO'^lc 



108 JOURNALISTIC INSIGHT. 

Dr. Oliver Wendell Holmes, in his picture of James Russell 
Lowell as a critic, gives an excellent description of this power : 
"He is the critic who is first to mark 
The star of genius when its ghnimering spark 
First pricks the sky, not waiting to proclaim 
Its coming glory till it burst in flame. 
He is the critic whose divining rod 
Tells where the waters hide beneath the sod; 
When studious search through varied love has taught 
The streams, the rills, the fountain-heads of thought ; 
Who, if some careless phrase, some slip-shop clause. 
Crack Priscian's skull or break Quintilhan's laws. 
Points out the blunder in a kindly way, 
Nor tries his higher wisdom to display." 

DISCUSSION ON DR. JOHNSTON'S PAPER. 

If. A. Jones — I would like to suggest that this paper be incorporated 

'n all medical journals. I think each one should take courage and we 

;ould improve our journalistic endeavors if we follow the suggestions laid 

down by Dr. Johnstone. It seems to me the view she takes is the proper 

C. H. Hughes— 1 would like lo commend the point and brevity and 
the language of the author. I think such papers as this are quite suggestive 
because they show point and positiveness, they know how and where to 
begin and when to stop. 



MAKING THE PLBLIC PARTNERS IN THE TRUTHS 
OF MEDICAL SCIENCE. 

By T. G. Atkinson, M.D., Chicago. III. 

ED[3;OR OF THE "mEDICAI, STAND.\RD." 

TWO propositions must be conceded if my argument is to be 
of anv effect. First, that in medical science, as in every 
other department of science which has to do directly with 
the public, no genuine or permanent advance is possible 
without the intelligent co-operation of the public itself. Second, 
that the communication now obtaining between medicine and the 
public, tlirough the latler's great organ, the lay press, is exceed- 
ingly unsatisfactory. 



jvGoo'^lc 



T. G. ATKINSON, M. D. 109 

I do not anticipate any serious exception to either of these 
propositions from a body of medical editors. The President of 
the American Medical Association gave utterance to the truth, 
in what may be regarded as a representative and semi-official 
way, in his inaugural address in Chicago last year. "No perma- 
nent advance will ever be made in medical science," he said, in 
effect, "unless the people are made copartners in the truth." He 
further courageously and keenly declared that "he had an abiding 
faith in the public, that he believed in it, that when made to 
think, the public always reaches a wise solution to every problem, 
and that the key to a safe public opinion is to make the public 
think." Wise words, worthy of, and pertinent to, the present 
situation in medical science. The only amendment I would make 
to them is to drive their significance a little deeper into basic 
principles. 

The admission of the public into the truths of medicine is 
not simply a courtesy which medicine owes to the peojJe — not 
only a matter of expediency, even, for medical science itself — it 
is a constitutional right of the public. Medicine is a but a special- 
ized branch of the world's work; and as a stream cannot rise 
higher than its source, so the efficiency and intelligence of this 
division of work cannot be any greater or less than the public rela- 
tion toward it. The medical profession — a truth which I fear the 
profession is in frequent danger of forgetting — is but a repre- 
sentative body of men delegated by the public to do this special 
work, which is ultimately a function of the public — a committee, 
so to speak, appointed-by the public upon this special subject, and 
required to report to the general assembly. The fact is, that the 
official recognition of the situation by the medical profession is a 
trifle tardy. The public has already given unmistakable indica- 
tion that unless it displays a liltJe more frankness, it stands in 
grave danger of forfeiting pubhc confidence. 

My second proposition will certainly meet the endorsement of 
every intelligent medical man. There is no room for question 
that the exploitation of medical science now being given by the 
public press is utterly unsatisfactory. Dr. Crile, of Oeveland, 
in a recent address said: "The present relations between medicine 
and the press are unsatisfactory to all concerned, especially to 
medicine." With the latter part of His statement I do not agree ; 
I believe that the public are the chief sufferers. But his central 



)vGoo'^lc 



110 MAKING THE PUBLIC PARTNERS. 

assertion is unquestionably true. The sporadic items of informa- 
tion upon medical levies now appearing from time to time in the 
daily press are of so grotesque a character that they would be 
ludicrous if they were not so serious. Under present conditions, 
it is fairly certain that the public stands no chance of receiving, 
through the public press, any proper enlightenment upon the 
truths and progress of medical science. 

Yet it is equally certain that the lay press is the only agency 
by which such public partnership in medical truth can be ade- 
quately achieved. This constitutes a third proposition, to which I 
expect your assent as a body of editors — for I do not forget your 
general acquiescence in my last year's doctrine that medical edit- 
ing is a specialty of journalism rather than of medicine, and this 
position involves the corollary that the proper agency for dissem- 
inating medical knowledge to the public is the public press. Cer- 
tainly we cannot expect to reach the public through our medical 
journals, even the most radical of them. And for reasons which 
I shall afterward adduce, it is neither wise nor effective for the 
profession to try to reach the public through literature or lectures, 
except for very specific and limited purposes, such as hygienic 
instructions and the like. 

Nor is this all that we, as medical editors, must concede in 
this direction. Whatever the medical practitioner may think, who 
is a specialist in medicine, we, who are specialists in journalism, 
must further allow that the public press shall carry out the task 
in its own appointed way, and that this way is the right way. 
This is, in my judgment, the crux of the whole situation. TTie 
medical profession wants to give the public a horse, and keep a 
string tied to it. It is agreed that the time is ripe for taking 
the public into its confidence, but the profession proposes to dole 
out its confidences in a paternal way, in such doses and by such 
methods as it thinks the public ought to have them. 

It is useless to expect to enlist the public press in any such 
plan of paternal education to any effective extent. It is not 
the function or the habit of the lay press to carry out educational 
propaganda of this kind, nor can any really effective enlightenment 
in medicine or any other subject be brought about by a deliberate 
attempt to "educate." Public education does not come about 
by this sort of forced campaign, but by a natural, unconscious 
process and selection of facts and the people are, after all, — 



)vGoo'^lc 



7". a. ATKIXSOX, M. D. HI 

hard as the lesson seems to be for us physicians to learn — 
their own best assorters and interpreters of the facts. 

It is not for the profession to complacently and paternally 
decide in what subjects the public shall not be educated. What 
the public needs, and rightfully demands, is that the salient 
facts and truths of medical science shall, from time to time, 
be freely and frankly laid before it, as they transpire. It 
neither requires nor cares for the technicalities of medicine — 
it is for that aspect of medicine that it delegates the profession 
as its agent. But technicalities pertain to forms and modes, not 
to truths, and there is no essential fact or truth of medical 
science which canttot be put before the public in terms of the 
rest of its kncnvledge. The public will decide, through its 
agency, the pubHc press, far more unerringly and adequately than 
the medical profession, what the relative usefulness and im- 
portance, to itself and its welfare, of the various facts and 
truths. 

With all its faults, the daily press is the only form of 
journalism that understands and carries out this principle, 
and to this principle and method it owes its tremendous power 
over the minds and conduct of the people. Even the editorial 
has dropped into practicial disuse in the modern lay press ; 
the people write their own editorials, unconsciously, from the dis- 
semination of news. One medical writer proposes that, as all 
of the great dailies have their sporting and financial editors, they 
should also have a medical editor to exercise his discrimination 
about medical articles. It must be borne in mind, however, 
that these department editors do not attempt any didactic educa- 
tion of their readers in sporting or financial matters. They 
simply select and present to the reading public such happenings 
in their departments as their editorial judgment deems inter- 
esting, and from an unconscious absorption and assimilation 
of these items the public learns its lessons and forms its habits 
of thought. A medical editor on the daily press would have to 
be a man with the journalistic instinct predominant, following 
out the same editorial (not paternal) dissemination of medical 
news, if his infiuence is to be equally useful. 

Of much more vital importance is the relation and attitude 
of the medical profession itself to the lay press ; for it is from 
the medical profession and its sphere of action that the lay 



jvGoo'^lc 



112 MAKISG THE PUBLIC PARTXERS. 

press — whether a lay or professional editor — must draw its 
news. I make the same point in this respect that I made last 
year in regard to the medical public — what they want is not to be 
preached to, but to be given the news. They want to know 
"what's doing" in medicine and surgery. If it is the sense 
of the profession that the pubhc should be made partners in 
its truths, and that the lay press is the proper and only agency 
of communication, then the profession can no longer expect 
to exercise a paternal and didactic censorship of the medical 
news to be disseminated, but only an editorial censorship, i.e , 
a selection of what is interesting to the public and a care for its 
truthfulness. Recurring to the illustration of the sporting and 
financial editorship of the lay press, it must be remembered that 
the press is given full and free access to all that the sporting 
and financial world and its exponents have to offer. Its repre- 
sentatives have their place in every function of the sporting and 
financial spheres; sporting men and financiers permit themselves 
to be frankly interviewed, and withhold nothing, except in behalf 
of special interests, and medicine has no special interests. 

It is here, I think, that the medical profession is at fault 
in its attitude toward the public press. According to the present 
ethics and policies of the profession, the public press finds 
every door to reliable information on medical doings and sub- 
jects barred, and can hardly be blamed if, in an excessive 
zeal for news, it exaggerates and distorts such items as occa- 
sionally spill over into its ken. It is high time that all of these 
stupid barriers which have been so long maintained between 
profession and public be swept away. The physician should 
be permitted all the avenues of approach to and influence over 
the people — including the public press — which are open to any 
other man. The doors of communication between the medical 
profession and the lay press should be thrown wide open, as 
is done in ail other departments of hfe, regardless of the apparent 
melee that may attend such a freedom, and the public trusted 
to perform its own discrimiation and evolve its own education 
in medical matters. 

I desire again to strongly condemn the idea, prevalent 
among medical men, that the public is incapable of grasping 
truths pertaining to medical science. The so-called confidences 
and communications made by organized medicine to the public 



)vGoo'^lc 



T. G. ATKINSON, M. D. 113 

are ludicrously stilted and arbitrary, like the didactic explanations 
of a teacher to his school children, and the real informing 
essence of the matter, and the current happenings, are with- 
held under the impression that the public cannot understand 
them. And thus the whole spirit of the purpose is missed; for 
it is not enough that the public shall be complacently and patron- 
izingly "educated" in matters that pertain to medical science; the 
people must be made copartners in its truths. 

There is but one adequate agency of public dissemination: 
the agency which, in spite of its faults and abuses, is after all 
the one great commonizer of human knowledge, and the clearing 
house of human progress — the public press. Sooner or later, 
medical science must lay aside its priestly exclusiveness and 
avail itself of the medium of the public press. And it is logically 
our part, as medical editors, who stand for the public relations 
of the doctor rather than his institutional relations, to blaze the 
way to this state of affairs. If we are specialists in journalism, 
dealing with medicine, we owe a duty to journalism, to see that 
the rights which we claim for our own little comer of it are 
extended to the public aspects of medicine. As a specific step 
toward establishing frank communication between medicine 
and the public, I suggest that this Association of American 
Medical Editors, through a properly appointed committee, open 
official negotiations with auth.>ritative representatives of the 
great lay press organizations, looking toward a thorough canvass 
and satisfactory solution of this highly important question of 
making the public copartners in the facts and truths of medical 
science. 

THE QUESTION OF ABSTRACTS. 

By Heinrich Stern, M. D., N'aw York. 
Editor Archives of Diagnosis. 

EXCEPTING those medical journalists who have no serious 
opinion upon the subject, it is safe to state that there 
are as many conceptions of an abstract of a medical 
article as there are medical editors. Some time ago the 
man at the helm of a well-known publication pointed out to me 
that to abstract is to steal without being noticed (he meant by 
the subscribers) and to take over the entire article, skin, feathers 



D.qmzoiibvGoO'^IC 



114 THE QLESTIOX OF ABSTRACT. 

and all, with possibly slight alterations in the introductory and 
concluding paragraphs. Another purveyor of literary food, who 
is known for his urbanity, when interrogated by me about his 
idea of abstracts, blurted out; "An abstract, if you please, is 
neither more or less than any reference to a printed argument." 
These two etlitors expressed about the view-extremes as far as 
abstracts are concerned ; one quarter advocates total appropria- 
tion, the other considers even the merest allusion sufficient. Be- 
tween these extremes there prevail all shades of opinions in 
respect to abstracts. Editors, in compliance with their individual 
standards, tastes and prochvities, are wont to look at them as 
either condensations, summaries, excerpts, digests, gleanings, se- 
lections, abbreviations, synopses, outlines, or what not more, and 
even each of these conceptions is variously defined by the various 
editorial supervisors. Of course, many journals have their own 
type of readers, and for argument's sake I will allow that the 
majority of subscribers to certain medical periodicals had the 
same educational advantages, have similar professional experi- 
ence and needs, and possess an aHke desire to keep abreast of 
the times. Now. if these premises do exist, wouldn't it be 
logical that the abstracts be prepared in a uniform manner, and 
that, irrespective of their form and character, they would con- 
vey to the peruser the sum and substance of an essay or article? — 
And again, wouldn't it be reasonable to expect that a matter 
once taken up in an abstract, be again considered in abstract form 
in subsequent issues of the periodical, if new literature pertain- 
ing to the point at issue has appeared meanwhile? 

True enough, there are a few American medical publications, 
some weeklies and some which are devoted to the interests of a 
specialty, which bring in the form of abstracts nearly everything 
which comes along — the weeklies with very little discrimination, 
the special journals by barring only the material emanating from 
a confrere who is persona non grata with one or the other of 
the editorial staff. But leave well enough alone, for the few 
journals just alluded to have abstract departments which appear 
to be regulated on certain broad lines. This is, however, not the 
case with the great majority of medical periodicals published in 
this country. Their abstracts, as a whole, neither reflect the real 
progress in medical thought and art, nor are they gotten up or 
collected with any other end in view than that of filling the 



)vGoo'^lc 



H EI N RICH STERN, M. D. 115 

pages. They are not prepared in accordance with a uniform 
standard and for a specific clientele, so often referred to as "the 
class of readers reached by us," for some of these abstracts are 
intelligible to the specialist only, while others are rehashes fit 
for the layman's understanding, and not a few are covered with 
the cobwebs of antiquity. 

What, then, is the logical conclusion? There is only one, 
namely, that not sufficient attention is bestowed upon the abstract 
section of their .publications by the gross of medical editors. 
The abstracts are procured in a haphazard way ; a number of 
journals Have them prepared by impractical, incompetent, under- 
paid, hectic doctorlings, others (some of which I held in high 
regard before I entered the editorial field) swell their bowels 
"in sudore vultus alieni," in the sweat of the face of another. 
But do they at least pilfer with discrimination? Do they separate 
the chaff from the wheat, or do they even pretend to know "a 
hawk from a hand-saw?" 

The disharmonious conglomeration of stolen goods is spread 
before the gullible medical public month after month; their 
source is never revealed, for if it were, if due credit were given 
the periodical that has brought the original excerpt, the matter 
would not be one of theft, but a perfectly legitimate and well- 
established journalistic custom. As a rule, it is from the most 
recently arrived exchanges that the abstracts are removed with 
pocket-knife or scissors. And these exchanges, in all likelihood, 
have clipped their abstracts from other periodicals, and thus the 
case becomes one of "the hand that shook the hand of John L. 
Sullivan." 

Is it not rather comical to behold a journal published in a 
dark corner of the hinterland parade with unsigned and un- 
credited abstracts — real editorial work, if you please— purporting 
to come from the Annales de I'Institut Pasteur, the Archiv fur 
experimentelle Pathologic und Pharmakologie, the Contes rendus 
de I'Academie, Hofmeister's Beitrage zur chemischen Physiologic, 
etc., when you know that not a single copy of these ultra-scientific 
publications have ever come nearer than 500, nay 1,000 miles, 
of the erudite editor's seat; when you are positive that neither 
he nor any one connected with his sheet has sufficient knowledge 
of either French or German to translate, digest and summarize 



t,;c=byG00<^lc 



116 THE QUEST/OX OF ABSTRACT. 

as a matter of which, at the best, he has but a very faint intima- 
tion. 

Indeed, is it not jarring when you see one of your abstracts, 
in the preparation of which you had spent A number of hours 
in the large library of the medical centre, repubhshed in another 
journal without receiving credit for yourself or your publication? 
The abstraction of abstracts (without acknowledging the source 
whence derived) is larceny, and it remains larceny no matter 
how plausible an excuse is made for it. Yet, I pity the editorial 
souls that have sunk so deeply. But after the words of the 
immortal Virgil let us act, "Ignavum fucos pecus, a praesepibus 
arcent," "Drive from their hives the drones, a lazy race." 

And now back to our theme, the abstract itself. What would 
be its definition from my personal standpoint? An abstract 
should be the condensation of all or a portion of that which is 
substantially new in an article, or novel in the interpretation of 
already known facts. It should, therefore, record a novation 
of some kind. 

This conception of an abstract presupposes at once that the 
director of the abstract department of a medical publication 
should be an important member of its editorial board. He must 
be well-informed of the general medical knowledge of the times, 
and must at least be able to understand French and German, 
unless there be efficient translators connected with the editorial 
slafiF. He should be well versed in the current medical literature, - 
and, in fact, in the literature of the past four or five years, and 
should know at a glance whether an article is based on personal 
experience, or whether it is a compilation, paraphrase or pla- 
giarism. He should be able to rend asumler verbosity and facts, 
the old and the new, and to set forth .such facts and that which 
is new in direct and plain language. He should adhere to a 
certain standard of uniformity and keep before the reader the 
later developments of a subject di.scussed in the form of abstracts 
on previous occasions. And finally, he should display enough 
courage to refrain from abstracting the article of the big pro- 
fessor or a personal friend, if the article does not merit it, and 
to reject, if they do not come up to his standard, the abstracts 
furnished gratuitously by the ren.iwned and influential specialists, 
whose full names, like chesty drum-majors, parade at the head 
of their respective divisions. 



)vGoo'^lc 



HElSRtCH STERN, M. D. 117 

Many publishers of medical journals do not appreciate how 
highly the average subscriber values the good abstracts. They 
will seem to think "Where none admire, 't is useless to excel." 
Let them put a competent man in charge of the abstract depart- 
ment and they will see how quickly the delinquent subscriber 
remits his dollar or two. 

More than 90 per cent of all articles as thej- appear in the 
international medical press are compilations or paraphrases. 
While the usefulness of a good compilation cannot be denied, 
the fact that it itself is composed of excerpts and condensations 
should a priori preclude its renewed abstraction. The limited 
space in the abstract department is needed for the recording of 
novel experiences, facts and interpretations. The great majority 
of case-reporls are compilations. They bring nothing original, 
except, perhaps, the case-report itself (and hundreds of similar 
cases may already be on record) which usually takes up but a 
comparatively small fraction of the article ostensibly devoted 
to it. The great bulk of it is more or less unnecessary rehash 
taken from previous articles on the subject or from text-books. 
This ballast which is to lend weight to a flimsy case-report is 
unmitigated chaff as far as the abstract is concerned. And it is 
just this frippery, occluding so many pages of the average abstract 
section, which is often shown off as the real thing in the progress 
of medicine. If there seems to be something of unusual interest 
in a case-report, it may, if necessary, be republished in its en- 
tirety, but the frills and feathers have no business whatsoever 
in a seriously conducted abstract department. 

Paraphrases, like good compilations, often serve a distinct 
purpose. Generally speaking, they set forth a certain subject 
in a clearer and more impressive manner as did the original 
article thereon, but they do not in themselves express a new 
truth. As a matter of fact, every maker of an abstract .should 
be an efficient paraphraser; in other words, he should be able, 
by clarification of the language and improvement of the form, 
to convey the author's ideas and conclusions in a better way than 
the perusal of the original paper will afford. Efficiency in para- 
phrasis cannot be expected in a journey man-doctorhng, but the 
latter knows, as a general rule, a good thing when he sees it, 
and he abstracts with the scissors a part or the entire paraphrase 
made by another, and thus the original paraphraser advances 



zccb/Goot^lc 



1J8 THE QUESTION OF ABSTRACT. 

often to the class of the original thinkers and investigators. 
Smith, for instance, paraphrases Jones' work which has been 
published in an obscure volume of transactions. Smith's para- 
phrase, which may or may not directly refer to Jones' original 
mvestigations, is perfect in form and expression, and appears 
in a prominent periodical. The man with the shears, of course, 
only knows Smith, and Smith becomes the originator, the leader, 
the great man. But poor Jones, alas, sinks into oblivion. 

While over 90 per cent of all medical articles are compila- 
tions or paraphrases, more than 95 per cent of the general run 
of abstracts, as we find them in a majority of American medical 
publications, are condensations of such compilations and para- 
phrases. Is this fair to the subscribers, fair io the modest 
thinkers and investigators? 

If a medical publisher thinks that he cannot afford a well- 
trained director for his abstract department, he should either 
discard it altogether, or conjointly with other publishers, who 
are in a similar predicament, should secure the services of a 
competent abstractor at one of the medical centres, and pay his 
pro rata share. 

A great dealmore could be said on this question, but I will 
conclude at this point, satisfied to have shown you where the shoe 
pinches. 

DISCUSSION ON DR. STERN'S PAPER. 
W. C. Abbott— This paper is an admirable one on just what we 
all have to deal with each day. From his standpoint, it is all right, but we 
are not all as competent as he is. He don't stop to think that we don't 
all live in the scientific world that he does and a lot of our readers don't 
live in even as scientific a world as we do, therefore I beheve our chief 
consideration should be for those who ate going to read our abstracts for 
good and benefit, not necessarily (o make an ideal abstract and therefore 
our abstracts need not necessarily be devoted to something new. 

What you and I have known for a long time may be new to some- 
one else, therefore our chief thought should be to have our abstracts con- 
tain information that will be of working value to our readers. 

The average subscriber to the average journal wants in his ab- 
stract that which will help him and I believe Dr. Stern will accept this 
suggestion and see the point. Our readers often need that which Dr. 
Stem in his more scientific field would deny him. There are, perhaps, not 
ten efficient abstractors connected with all the journals of America. It is 
d business in itself, the ability to give in a few words what the author has 
taken pagts to convey. This is a great thing, but the man who will go 



)vGoo'^lc 



HEINRICH STERN, M. D. 119 

down through the future, is the man who gives his readers that which 
they can use and profit by. 

Dr. Heinrich Stern, in closing, said : I have nothing to add, but will 
say a few words in reply to what Dr. AUiott has said. This is not a 
question of scientific abstracting, it is a question of honesty. 1 did not 
think of scientific abstracting. 1 am here in New York preparing an ab- 
stract, let us say, for some little journal in the west Many little journals 
will take an abstract and publish it without mentioning its source. That 
was the reason why I wrote this paper. 

My other point is that it is for the good of the editors that we have 
a uniform class of readers. Most journals in a certain section of the 
country say that they go to a uniform class of readers. When they go 
to an advertiser they sayi 'The class of people reached by us." Why 
don't they do the same thing in abstracting; why not in the editorial work. 
In your editorial department, live up to the claims you make in your ad- 
vertising or any other department. Give your readers the veiy best thera- 
peutic help you can, but in all your writing, aim to be a little above your 
reader's intelligence so that you educate him, 

I want to call particular attention to the fact that we should have 
someone in the editorial office particularly trained to do the abstracting. 
He need not necessarily be scientific, but he must be able to pick out the 
essential parts of an article and put them together as they should be. 



THE EDITOR AND HIS EDITORIAL. 

By W. H. Neilson, M. D., Milwaukee. 
Editor Milwaukee Medical Journal. 

IN choosing this subject, I am not unmindful of the possibility 
that in its elaboration something may be said liable to mis- 
construction. Far be it, however, that any thought of mine 
should have anything in it but the kindliest for my brother 
editor. Neither need you expect criticism from me from whom 
criticism would fall most ungracefully. What I hope to say 
shall simply embody those ideals of the editor and his editorial 
for which I aim, but of which, alas, I so often fall short. Never- 
theless, it is well to have ideals at which to aim, and if my bow 
string is so loose or my arm is so weak that my shafts fall short 
of their mark, yet am I the gainer by the experience and I can 
hope with a tauter string and an arm made stronger by practice 
to send my arrows hurtling to their mark. Thus, with high 
ideals and undiscouraged effort to attain them, we may win the 
prize, or at least be made stronger by the effort. I firmly believe 
that the medical editor should, of all men, be a man of high 



)vGoo'^lc 



120 THE EDITOR AND HIS EDITORIAL. 

ideals. His is a high calling and upon him rests a great respon- 
sibility. UpotJ him devolves the dnty of counsellor and guide to 
his readers far more than being a mere purveyor of medical 
thought. 

The young man is largely guided in matters of ethics of 
right living, of his relations to his fellow men, by the editorials 
appearing in his medical journal, while the older man in practice 
and years gains much of his food for thought from the same 
pages. The medical journal is supposed to convey into the re- 
motest hamlet or country cross-roads, the latest advances in 
medicine and the best medical thought of the world. How care- 
'ful should the editor be that nothing finds entrance to his pages 
which, while passing for medical thought, may not be such, but 
rather be unmitigated delusion, capable of doing great harm. 
How often, too, is an operation successful and proper, in skilled 
hands, heralded in the journals as one to be made with com- 
parative ease, appropriated by the incompetent to their and their 
patients utter undoing. Likewise, new drugs and new methods 
of treatment are seized upon by the untrained or seeker after 
notoriety who exploits them with disaster to himself and his 
victims. 

These operations, these treatments, these drugs may be most 
beneficial in the proper hands, but powers of destruction in the 
hands of the heedless, the untrained, the seeker after notoriety. 
It is, then, with a great sense of responsibility that the editor 
should select his material and develop his editorials. I have no 
sympathy whatever for the legend so frequently appearing in 
our journals; "The editor does not hold himself responsible 
for views expressed in these pages." To my mind, he should 
hold himself responsible, or, should he admit what he considers 
gallacious, he should be at pains to point out wherein the fallacy 
lies. He should at all times remember the power for ill there 
lies in statements not based upon scientific truths or practical 
experience, and that it is his bounden duty to mitigate that power 
in so far as in him lies. Indeed, it is for him to stand between 
error and those who might be injured thereby. 

A large part of one's medical education is derived from the 
medical journal. After a young man has secured some degree 
of practice, the exigencies of his work do not permit him to 
study the text-books, nor do the monographs appeal to him with 



)vGoo<^lc 



II'. H. XEILSOX, M. D. 1^1 

the same directness as does the medical journal. It is to it that 
he turns in his spare moments, and from its pages does he gain 
knowledge of the advances made along medical lines and through 
it is he enabled to keep abreast of medical thought. The medical 
editor, then, is a post-graduate teacher whose teachings influence 
a large student body. How important that those teachings should 
ring true. 

Above, I have said that a young man is largely guided in 
ethics by his journal. I believe this to be true, not only in 
medical ethics as we understand them, but in the broader sense 
which embraces his social and moral attitude. Young men freed 
from home ties and cast into an environment not always the 
choicest need moral bracing as well as continued mental train- 
ing; and, while we should not turn a medical journal into one 
for moral teaching, we should at least see to it that nothing 
enters our pages that would weaken their faith in the great prin- 
ciples of cleanliness and right living. 

From a wide perusal of medical journals, I am happy to say 
that the journals are very few which allow anything unclean in 
their pages, yet, here and there appear articles which could only 
be the emanations of prurient minds. These unclean articles 
necessarily have their influence, for everything has, and their 
reading may be the turning point between decency and indecency 
for those not well grounded. It is as if our honorable body had 
received a blow, that an attempt had been made to degrade us 
whenever such articles appear. We are judged by our fruits, 
and the fruits of uncleanness and unrighteousness are very bit- 
ter, and, when offered for sale in the world's market, bring but 
a sorry price. But the editor, true to his calling, will not tolerate 
the questionable in morals any more than he will the question- 
able in science. His endeavor will always be to keep his pages 
clean, and in so doing, dignify not only himself, but his pro- 
fession. 

The dry dust of scientific detail is, as a rule, not overly 
appetizing to the average reader, and in order that it may be 
appreciated and digested, it is often necessary that it be served, 
garnished and with various relishes. It is here that the per- 
sonality of the editor should have full sway. It is possible to 
make the most uninviting truth palatable and nourishing by 
presenting it savored by individuality. A portrait may be flat 



)vGoo'^lc 



123 THE EDITOR AND HIS EDITORIAL. 

and- unattractive, but a shadow here and a high light there, 
placed by the master, may bring it out in Hfe-like beauty. So 
may we, by a touch of our pens, here and there, illumine what 
might be passed by as dull and uninviting. We should, there- 
fore, seek not to merge ourselves in the inconspicuous level, 
but rather, to cultivate whatever talents we may have in pre- 
senting in vivid coloring what otherwise might be colorless and 
uninteresting. It is needless, then| to say that the editor should 
seek to have a complete grasp of the salient points of papers 
presented, and should, by his reading, familiarize himself with 
the prominent topics of the day, as well as have that practical 
knowledge which shall enable him to separate the practical from 
ihe merely theoretical, giving to each its just value. This neces- 
sarily argues good mental equipment and alertness of mind. It 
should, therefore, be our duty, to seek by every means at our 
command, by study and observation, to so prepare ourselves that 
we come close to this ideal. 

The editorial, then, whilst dealing with matters of science, 
ethics or of general interest, should, in order to be successful, 
reflect the thought, the knowledge, the cleverness in the art of 
depiction of a mind well trained. To be successful, it should 
contain nothing of bitterness, of self seeking nor of captious 
friticism ; it should be clean, scientific, breathing the warmth of 
brotherly love and exuding the milk of human kindness. 



A JOURNALIST'S BRIEF CONSIDERATION OF LIBEL. 

By J. I. Taylor, M. D., Philadelphia. 
Editor "The Medical Council." 

IF only one man lived in the world he could probably get along 
without law. But where two or more exist where their 
interests are likely to come into conflict, it is necessary that 
certain rules and regulations be mutually agreed upon where- 
by neither one will trespass upon the natural or acquired rights 
of the other. In our organization into a human society it is 
assumed that none of us shall be allowed to do a wrong to 
another. The rules of restraint have been formulated into definite- 
ly expressed laws, with rules for proceedure to secure conviction 
and punishment. 



jvGoo'^lc 



/. /. TAYLOR, M. D. 123 

In pursuing this subject we find that there is one general 
class of ofltenses known as torts. The peculiar fact about the 
word tort is that it is not susceptible of exact definition, in this 
respect differing from all other legal terms. An attempt to define 
it resolves itself into simply giving a list of the different torts 
and to attempt to classify them. On the one hand, it overlaps 
the law of contracts, and on the other hand criminal law, but 
most of it lies between and not included in either of these. 

One of the most important of the offenses known as torts 
is that of slander and libel, slander being an offense by words 
spoken or Indicated by physical signs, and libel being an offense 
committed by printed or written words, drawings, hieroglyphics, 
or other permanent representation by which the offensive mean- 
ing may be understood, and publishing of the same by allowing 
it to pass into the hands of a third person. In the consideration 
necessary for this paper only such portions of the subject will 
be treated as relate particularly to publication by means of a 
magazine, book, or paper printed for circulation, and which is 
known technically in legal terras as a newspaper, omitting all 
references to the private circulation of letters, drawings, etc. 
The subject is so extensive that only general principles can be 
stated, an accurate knowledge of which may possibly enable one 
to avoid committing the offense in consideration. 

As medical journalists we all desire to perform our full duty 
towards the profession to which we belong and whose interest 
we are endeavoring to promote in the editing and publishing of 
our various magazines. But as private citizens wishing to con- 
form to the principles of the Golden Rule, we do not wish to 
trespass upon the rights of our fellow man in the practice of 
our profession as journalists. It is in the desire to ascertain 
just what we may do and what we must avoid that this paper 
is prepared 

Primarily every person is held in law to be entitled to the 
unmolested enjoyment of his private character and to his reputa- 
tion for business integrity and the reputation of the goods he 
produces. 

DEFINITION : Briefly, libel is the publication of that which 
produces a legal injury to the reputation of another and which 
is not true. It is a violation of our duty in that we owe it 
to our fellow man not to publish anything that may defame him. 



)vGoo'^lc 



124 A JOURNALIST'S BRIEF CONSIDERATION OF LIBEL 

Technically the definition includes language tending to bring 
the person of whom it is published into hatred, ridicule, or dis- 
grace or to injure him in respect of his vocation. It includes 
accusation of having committed crime, of having a contagious 
or infectious disease, of making derogatory imputation concern- 
ing him in regard to his office, business, or occupation, or making 
an imputation tending to disinherit him. 

Libel consisting of the pubUcation of seditious, blasphemous 
or obscene matter, also matter defaming the character of the 
dead, is the subject of criminal prosecution and punishment. 

It is not necessary that the libel be stated in distinct and 
positive terms. This is an important point, as most journalists 
do not understand it. It is libel if it so appears that anyone 
reading it may understand it as an imputation against the person 
libeled. That is, a hbel may be stated in direct, positive terms, 
or in an allusion, innuendo, or in merely a questiwi or questions. 
Moreover, any defamatory heading given to an article, or foot- 
note or comment following the article may be a libel, although 
the body of the article does not contain a libel. Any use of 
ironical praise or such statements as "we beheve so and so," 
"there is reason to beheve so and so," or "it is generally believed 
so and so" may justly come under the definition of libel. 

It is well to consider at this point before going further who 
are liable in the case of libel. It will probably surprise most of 
you to learn that all who directly assist in the production and 
circulation of a libel are equally hable. The writer of a libellous 
article, the editor, publisher, owner of the paper in which it is 
published, the printer, and whoever sells and circulates the paper, 
and whoever helps the progress and preparation of the publica- 
tion of a libel are all equally liable, and the person injured may 
bring action against any or all of these parties. This you may 
readily understand may often work great hardship upon wholly 
innocent parties, so far as any knowledge or intention of the 
offense is concerned. However, I believe it has been the custom 
of the courts to consider such circumstances in mitigation in 
determining damages or punishment. 

It is well also to consider here the nature of the limitation 
of liability, as to time. Whereas the original offense consists 
in the first publication of the offensive article, yet the offense is 
repeated by each additional sale or distribution of the article 



)vGoo'^lc 



;. /. TAYLOR, M. D. 125 

in question. Hence, the statute of limitations does not begin 
to take effect with the first publication, but with the last sale 
or delivery that can be proven of the publication containing the 
article. Thus, if publication first took place two years ago and 
a subsequent delivery of even a single copy of the article can 
be proven to have occurred four years, or any number of years, 
hence, the offense is repeated and action can be taken within 
the statutory time following. 

PRIVILEGED PUBLICATION. 

If, under the literal definition the law of libel were strictly 
enforced, very few publications that have any strength of char- 
acter would be allowed to continue after the first issue. There 
are circumstances under which matter which would otherwise 
be libel is not so. A fair and honest report of judical proceed- 
ings, legislative proceedings, official reports in naval and military 
affairs is allowable. Fair and evidently not malicious comment 
upon the same is also allowable. This is in the interest of public 
policy as allowing the papers to inform the people of what is 
going on. Fair comment upon the public acts of officials or 
upon the productions of another, as a book, work of art, etc., 
is not libel if not accompanied by unnecessarily malicious ex- 
pressions. In this connection, it is well to speak of the question 
of the unnecessary manifestation of.mahce. It is always best 
to conduct any publication in a dignified manner. For example, 
it may be perfectly allowable to publish one's statement made 
at one time side by side with a statement made upon the same 
subject at another time, leaving the reader to infer that falsehood, 
hypocrisy, deceit, dishonesty or other offense has been com- 
mitted. This would not be libellous if the statement could be 
proven to be true. However, to accompany it with such epithets 
as "liar," hypocrite," "thief," "cheat," "fraud," etc., might make 
the publication libellous without adding anything to the strength 
of the presentation. In other words, truth presented in an in- 
suhing form is not justifiable. One may commit libel merely 
by an adjective or a picture. The courts take into consideration 
at least in mitigation of damages or punishment the fairness 
and good faith on the part of the person accused of libel. 
Privilege extends also to replies which one may make to another 
party in a controversy in which hard words may be expressed 



jvGoO'^lc 



]26 A JOURNALIST'S BRIEF CONSIDERATION OF LIBEL 

on both sides. In such a case, one is said to invite publication 
of his own affairs by an attack upon the affairs of another. 

Also, any one who puts forth statements and claims by 
proclamations, announcements, circulars, or advertisements there- 
by invites comments upon the claims and statements so put forth, 
and privilege in such comment will go a long ways. For ex- 
ample, if false or grossly exaggerated representations are made, 
this may be examined and refuted. This comes within the 
province of a newspaper in protecting the public against fraud, 
against loss of investments, etc. 

OTHER APPEALS TO THE PUBLIC. 
Whenever a medical man brings forward some new method 
of treatment, and advertises it largely as the best or only cure 
for some particular disease, or for all diseases at once, he may 
be said to invite public attention. So when a tradesman dis- 
tributes handbills or circulars, he challenges pubhc criticism. 
A newspaper writer is justified in warning the public against 
such advertisers, and in exposing the absurdity of their profes- 
sions, provided he does so fairly and with reasonable moderation 
and judgment. 

AS TO THE TRUTH OF STATEMENTS MADE. 

It is a general principle that only false statements can be 
libellous, as a person is not entitled to a character which he does 
not truly possess. This was not true under the old common 
law, and some of our states still adhere to the old principle, 
"the greater the tnith the greater the libel." hence it is well 
for every journalist to consult the statutes of his own state. If 
truth is plead as the justification for the publication it then may 
become a dangerous plea, as such a plea becomes a repetition 
of the libel, and if the truth of the statement is not proven, tends 
to make the punishment or damages greater. 

QUOTATIONS. 

Most persons are under the delusion that if they repeat or 
republish libel, giving the original authority, that this is not 
libel on their part. This is a very dangerous error, as republica- 
tion is no justification whatever. The injured person may bring 
action against the one who repuWishes, without taking any notice 
of the original source. Naturally he will choose to bring action 



JyGOO'^IC 



/. /. TAYLOR, M. D. 127 

against the most influential and financiaUy responsible persons 
who republish ; so we must be very careful in our quotations. 

RETRACTION. 

Most persons are also under the delusion that a retraction 
of a libel absolves them from every responsibility. This is not 
literally true, as it is assumed that a great deal of mischief may 
be created following the publication of an article before the 
retraction can be properly circulated ; also that some persons may 
see the original publication who may never see the retraction. 
Retraction is only taken by the court as an evidence of good faith 
and considered in mitigation of the punishment, but has no 
bearing whatever upon the question of guilt. However, an 
.agreement in writing on the part of the injured party to accept 
retraction will bar him from further action against the defendant. 
He thus waives his privilege of bringing action. On the other 
hand, a refusal to retract is taken as further evidence of malice, 
and is likely to increase the degree of punishment. 

It is well here to speak particularly of publications which 
injure one in respect to his business, profession or trade 

Any false statement accusing one of incompetence, dishon- 
esty, unprofessional conduct, or other offensive language tending 
to injure him in the conduct of his business or profession is 
libellous. In connection with this, we should consider what is 
technically known as slander of goods manufactured or sold by 
another. An untrue statement disparaging a man's goods, caus- 
ing him special damage is actionable. This rule applies even 
though no imputation has cost him his private or professional 
character. 

NEWSPAPER LIBEL. 

It is the right and duty of newspapers to discuss measures 
relating to the morals, health, welfare, comfort, and happiness 
of the people. But this gives them no immunity from liability 
in publishing a libel other or different from any other person. 
The law makes no distinction between him and any private 
person who may publish an article in a newspaper or other printed 
form, and if either abuses the right to publish his sentiments on 
any subject and upon any occasion, he must defend himself 
upon the same legal ground. The publisher of a newspaper is 
liable for everything appearing in its columns, though he was 



jvGoo'^lc 



128 A JOl'RNALISTS BRIEF CONSIDERATION OF LIBEL 

ignorant of or even forbade the publication. He is liable though 
he believed it to be true and acted in good faith. 

JOURNALISTS AS THE OBJECTS OF LIBEL. 

It is libellous to impute to the editor and proprietor of a 
newspaper that in advocating the sacred cause of the Dissemi- 
nation of Christianity among the Chinese he was an impostor, 
anxious only to put money into his own pocket by extending the 
circulation of his paper; and that he has published a fictitious 
subscription list with a view to induce people to contribute. 
(Campbell v. Spottiswoode, 3 B. & S. 769 ) 

It is libellous to write and publish that a newspaper has a 
separate page devoted to advertisements of usurers and quack 
doctors, and that the editor takes respectable advertisements 
at a cheaper rate if the advertisers will consent to their appearing 
in that page. {Russell and another v. Webster, 23 W. R. 69,) 

It is libellous to call the editor of a newspaper a "libellous 
journalist." (Wakely v. Cook and Healey, 4 Exch. 511.) 

An article published in a newspaper falsely charging the 
publisher of another paper with being a party to a secret con- 
clave, in which he sold the support and advocacy of his paper 
to certain corporations for a sum of money, is libellous. (Fitch 
V. DeYoung, 66 Cal. 339.) 

It is not libellous for one newspaper to call another "the 
most vidgar, ignorant and scurrilous journal ever published in 
Great Britain," but it is hbellous to add "It is the lowest now 
in circulation ; and we submit the fact to the consideration of 
advertisers" ; for that affects the sale of the paper and the profits 
to be made by advertising. (Lord Kenyon. C. J.) Heriot v. 
Stuart, I Esc|. 437. 

Charging a physician with gross and culpable neglect and 
oversight in the treatment of his patients is libellous. Secor 
V. Harris. 18 Barb. (N. Y.) 425; Summer v. Utley, 7 Conn. 257; 
Carroll v. White, 33 Barb. (N. Y.) 616; Pratt v. Pioneer Press 
Co., 35 Winu. 251; Berghold v. Putcha, 2 Thomp. & C. 532; 
Johnson v. Robertson. 8 Port. 486; Tutty v. Alewin, 11 Mod. 
221; Onslow v. Home, 3 Wils. 177. 



jvGoo'^lc 



/. /. TAYLOR, M. D. 



ADVERTISEMENTS. 



Most persons think that libel applies only to articles in the 
reading pages of a publication. This is a great mistake, as 
statements made in the advertisements may be e([«ally libellous 
and those who conduct the publication as well as the advertiser 
himself are equally r.esponsible. How many of us censor tlie 
advertising copy sent in each month to see whether our adver- 
tisers are knocking their competitors, and thus possibly rendering 
us responsible for its publication. 

In conclusion, that journal will have the greater influence 
which is conducted in a spirit of dignity and moderation, realizing 
the two-edged sword of a public medium, and confining jts 
adverse criticism mainly to a presentation of facts only, of which 
the editor holds full legal proof, and leaving the reader to draw 
his own inferences. The spirit of kindness should prevail, first 
privately, endeavoring to lead an offender to voluntarily take 
steps to reform before exposing him to public contumely, from 
which he can never wholly recover. 

In conclusion, I recommend that each member procure and 
read Odgers on Libel and Slander, or Townsend on Libel and 
Slander, being the best, concise treatises on the subject. 



INDIVIDUALITY IN MEDICAL JOURNALISM. 

By J. M. French, M. D., MUford, Mass. 

Associate Editor of Journal of Therapeutics and Dietetics. 

ALL the strong, really successful, influential medical journals 
of which I have any knowledge have this one characteristic 
in common : that they have an editor of strong person- 
ality, who succeeds in stamping his own individuahty upon 
every page of his journal, not excepting the advertising pages. 
This means a strong editorial department, under the absolute 
control of one man, who may have one or more associates, or 
any number of competent assistants, but who stands out before 
the profession as the one responsible editor. 

This is the same rule which has characterized successful 
journalism in every department and in all ages. It was not an 
impersonal newspaper which informed the minds, convinced the 



)vGoo'^lc 



130 INDIVIDUALITY IN MEDICAL JOURNALISM. 

judgments, and moved the hearts of the men of the loyal North 
during the Civil War; but it was the unique and forceful in- 
dividuality of Horace Greeley speaking through the columns of 
the New York Tribune, for every word of which, advertisements 
and all, he was popularly held responsible — and he never shirked 
the responsibility. 

It is sometimes said that the days of personal journalism 
are gone by. But I do not believe that human nature has greatly 
changed in all the ages. The Christian religion is the religion 
of Christ, not an impersonal system of doctrines and duties. 
Every movement for the uplift of humanity, to succeed, must 
have a leader ; and no great work was ever done, but some man 
put his life into it. 

A number of things besides an editor are needed to make a 
successful medical journal; contributors, subscribers, and ad- 
vertisers, for example ; but, given all the others, and still success 
is impossible without this one supreme thing, an editor of force 
and individuality, who will put his life into the journal. 



Preiident Crothers, in closing the session for 1909, remarked — As 
?his is th« close of the 'session I just wish to say a word in retiring. This 
narticular meeting and the one on Saturday have heen singularly strong. 
No two papers have covered the same ground. I hardly think that a meet- 
ing has occurred in which there have been so many independent and 
strong journals represented, and I think we may well congratulate our- 
selves that medical journalism has reached the degree of excellence that 
we can be proud of. 

I am grateful to you alt for having assisted me in doing my part and 
[ hope and trust that at the next meeting you will do equally well. Let 
us all try to make this the only society of its kind in the world. We rep- 
resent the best in journalism. Taken as a whole, American Medical 
Journalism is decidedly 100 years ahead of medical journalism in any 
other country, and this is due to the intense personality evidenced in our 
work. We have reached a point where we can stand alone, irrespective of 
all slights and criticism, so let us put our thoughts and attention to the 
things which tend to make our work better and better. 



)vGoo'^lc 



LIST OF MEMBERS. 



Xlst of flDemf>erd. 

Abbott, W. C., Chicago, Ills., American Journal of Clinical Medicine, 

Albright, J. D., Philadelphia, Pa., Albright's Office Practitioner. 

Amberg, EL, Detroit, Mich., Journal o( Michigan State Medical Society. 

Anderson, Wl., San Francisco, Cal., Pacific Medical Journal. 

Andrews, R. H., Philadelphia, Pa., Medical Summary. 

Atkinson, T. G,, Chicago, Ills., Medical Standard, 

Baez, M, Q., San Juan, Porto Rico, El Boletin de la Asociacion Medico de 

Puerto Rico. 
Ball, Otho F., St Louis, Mo., Interstate Medical Journal. 
Barnhill, J, U., Columbus, O,, Columbus Medical Journal. 
Beck, Carl, New York, Archives of Physiological Therapy. 
Besler, Fred. A- Chicago, Ills., Surgery, Gynecology and Obstetrics. 
Billings, J, S., Jr., New York City, New York Medical Journal. 
Bishop, F. B.. Washington, D. C„ Advanced Therapeutics. 
Bishop, S. S., Chicago, Ills., Illinois Medical Bulletin. 
Boskowitz, G, W., New York, Eclectic Review. 
Brickner, W. M.. New York, American Journal of Sut^ery, 
Brothers, S. F,, New York, Medico Pharmaceutical Journal. 
Bryce, C. A., Southern Clinic, Richmond, Va. 
Bulson, A. E., Fort Wayne, Ind., Fort Wayne Medical Journal. 
Burch, J. H.. Baldwinsville. N. Y., Journal of Advanced Therapeutics, 
Burdick A. S., Chicago, Ills., American Journal of Clinical Medicine. 
Burroughs, J., Asheville, N. C., Gaillard's Medical Journal. 
Butler, G. F., Chicago, Ills.. How to Live. 

Camp^ll. D. A.. Maritime Medical News, Halifax, Nova Scotia. 
Chamberlain, C. S. Cincinnati 0„ Lancet Clinic. 
Chase, I. C., Fort Worth, Tex., Texas State Journal of Medicine. 
Chassaignac, C, New Orleans, La,, New Orleans Medical and Surgical 

Journal. 
Coe. H, W., Portland, Ore,, Medical Sentinel. 
Coffman, J. J., Scotland, Pa., Charlotte Medical Journal. 
Co^e, Hills, New York, North American Journal of Homeopathy. 
Crothers, T. D., Hartford, Conn.. Quarterly Journal of Inebriety, 
Dalton, C. F., Burlington, Vt, Vermont Medical Monthly. 
Daniel, F. E., Austin, Tex., Texas Medical Journal. 
Dfrome, W. J., Montreal, Can., Le Journal de Medecine et de Chirurgie. 
De Saxe, G. A., New York, New York Medical Journal. 
Doering, E. J., Medical' Recorder, Chicago, III. 
Donc^hue, F, B,, Annals of Gynecolc^ « Pediatries, Boston, Mass. 
Dowling, O., Shreveport, La., Medical Recorder. 

Dyer, I., New Orleans, La,, New Orleans Medical and Surgical Journal, 
Eastman, F. C, Brooklyn, N, Y., Neurographs. 
Edwards, L B., Richmond, Va.. Virginia Medical Semi-Monlhly. 
Ellingwood, F.. Chicago. Ills.. Medical Times. 
Elfiott, George. Toronto, Ont,, Dominion Medical Journal, 
Eisner, J,, EJenver, Colo,, Colorado Medical Journal. 
English, D. O,, New Brunswick, N. J., Journal of Medical Society of New 

Jersey. 
Fassett, C. W., St, Joseph, Mo., Medical Herald. 
Fest, F. T, B., New Mexico, Journal of Physical Therapy. 
Fitch, W. E., Savannah, Ga., Georgia Journal of Medicine and Surgery. 
Fletcher, R., Washington, D. C„ Index Medicus. 
Foster, F. P., New York, New York Medical Journal. 
Poster, M. L,, New York, Annals of Ophthalmology. 



)vGoo'^lc 



138 LIST OF MEMBERS. 

Fox, G. H., New York City, Medical Review of Reviews. 

French, J. M,. MiHord, Mass., Journal of Therapeufics and Dietetics. 

Gaines, J. S. A., Nashville, Tenti., Southern Medicine and Sui^ery. 

Garrison, P. H., Washington, D. C, Index Medicus. 

Goldberg, H. G., Philadelphia, Pa., Annals of Ophthalmology. 

Goldstein, M. A., St. Louis, Mo., Laryngoscope. 

Goodwin, R J., St.' Louis, Mo., Interstate Medical Journal. 

Gradwohl, R. B. H., St. Louis, Mo., Medical Brief. 

Guttman, John, New York City. Ophthalmology. 

Haneman, T. H., New York, New York Medical Journal. 

Harrington, G. L., Brooklyn, N. Y., Brooklyn Medical Journal. 

Harris S., Mobile, Ala., Gulf States Journal of Medicine and Surgery, 

Hasencam]f, Oscar, Toledo, O., Toledo Medical and Surgical Reporter. 

Hatfield, M. P., Chicago, Ills., Chicago Clinic. 

Hawkins, T. H., Denver, Colo., Denver Medical Times. 

Held. R. J., New York City, Medical Review of Reviews. 

Hill, E. B., Denver, Colo.. Denver Medical Times. 

Hills, A. K.. New York, New York Medical Times. 

Hirschman, L. J., Detroit. Mich., Harper Hospital Bulletin. 

Hodgehead, D. A., San Francisco, Cal., Pacihc Medical Journal. , 

Holton, H. D., Brattkboro. Vt„ Bulletin State Board of Health. 

Honan, W. F,. New York City, Journal of Surgery, Gynecology and 

Obstetrics; 
Hopkins. T. A., St. Louis. Mo.. Medical Fortnightly. 
Howe. Pitts Edwin, Boston, Mass.. Journal of Therapeutics and Dietetics. 
Hughes, C. H.. St. Louis, Mo., Alienist and Neurologist. 
Hughes, G. O., Winnipeg, Can., Western Canada Medical Journal. 
Huntington, A. T., Brooklyn, N. Y., Medical Library and Historical 

Journal. 
Jepson, S. L., Wheeling. W. Va., West Virginia Medical Journal. 
Johnstone, Mary M. S., Chicago, Ills., Woman's Medical Journal. 
Jones, W. A., Minneapohs, Minn., Journal of the Minnesota Society and 

Northwestern Lancet. 
Tuettner, O.. Cincinnati, O., International Journal of Therapy. 
Kaufman, L. R., New York, The Chironian. 
Kellogg, J. H.. Battle Creek, Mich., Modern Medicine. 
Kelly, S. W., Cleveland, O.. Cleveland Medical Journal. 
Koenig, A.. Pittsburg, Pa., Pennsylvania Medical Journal. 
King, E. E., Toronto, Ontario, Can., Canadian Practitioner and Review. 
Kreidler. A- G., Cincinnati, 0., Lancet Clinic. 
Lademann, O. E.. Milwaukee, Wis., Medical Fortnightly. 
Lamb, D. S., Washington, D. C, Washington Medical Annals. 
Lanphear, E.. St. Louis, Mo., American Journal of Clinical Medicine. 
Lederman, M. D., New York City. Laryngoscope. 
I eonard, C. H., Detroit, Mich.. Illustrated Medical Monthly. 
Lewii, Frank C., Burlington, Vl., American Medicine. 
Lewis, D., New York, Medical Review of Reviews. 
Lewis, H. E.. New Ycik, International Journal of Surgery, 
Lindley, W., Los Angeles, Cal, Southern California Practitioner 
Litterer, W., Nashville, Tenn.. Southern Medicine and Surgery. 
Loughran, Fred'k W., New York City. Pediatrics. ' 
Macdonald, J., Jr.. New York. American Journal of Surgery. 
MacMurches. Helen, M. B.. Toronto. Ontario, Can.. Canadian Nurse. 
McKee, E. S.. Cincinnati, O.. Southern Medicine. 
McMurty, L S., Louisville, Ky., Journal Surgery. Gynecology and Obstet- 

MacPhail, A.. Montreal. Can.. Montreal Medical Journal 

Mantz, F. A., Philadelphia, Pa.. Medical Bulletin. 

Marcy, Henry O.. Boston, Mass.. Annals of Anatomy and Surgery. 

Martigny, F. De, Montreal, Can., Le Journal de Medecine et de Chirurgie 



)vGoo'^lc 



UST OF MEMBERS. 133 

Martin, F. H., Chicago, Ills,, Surgery, Gynecology and Obstetrics. 
Martinez, Y. G., Mayaguez, Porto Rico, Boletin de la Asociacion Medica 

de Puerto Rico. 
Mason, D., Montreal, Can., Le Journal de Medeclne et de Chirurgie. 
Matthews, J. M,, Louisville, Ky., Louisville Journal of Medicine and 

Surgery. 
May, C. H., New York City, Ophthalmology. 
May, James W., Kansas City, Kan., Kansas Medical Journal. 
Millican, K. W., St. Louis, Mo., St. Louis Medical Review. 
MofFatt, J. L., Brooklyn, N, Y., Homeopathic Eye, Ear and Throat Journal. 
Monihan, J. G., New York, Medical Examiner and Practitioner. 
Moyer, H. N., Chicago, 111. 

Monod, P., Montreal, Can., Le Journal de Medecine el de Chirurgie. 
Neitson, W. H., Milwaukee, Wis., Milwaukee Medical Journal. 
Outten, W. B,, Si. Louis, Mo,, Interstate Medical Journal. 
Palmer, G. T., Springfield, Ills., Chicago Clinic and Pure Water Journal. 
Palmer, A. W., New York, Homeopathic Eye, Ear and Throat Journal. 
Patek, A. J., Milwaukee, Wis., Wisconsin Medical Journal. 
Pfahler, G. E., Philadelphia, Pa., Archives of Physiological Therapy, 
Phelan, J. R,, Oklahoma City, Okia, Oklahoma Medical News Journal. 
Pitcher, James Evelyn, Carlisle, Pa., The Military Surgeon. 
Pilcher, Lewis Stephen, Bro<Alyn N. Y., Annals of Surgery. 
Pitcher, H. F., Haverhill, Mass., Advanced Therapeutics. 
Porter, E. H., New York, North American Journal of Homeopathy. 
Porter, William, St. Louis, Mo., London, Journal of Laryngology. 
Pratt, H. P., Chicago, His., American X-Ray Journal. 
Punton, John, Kansas City, Mo., Medical Index-Lancet. 
Register, Edw. C, Charlotte, N. C, Charlotte Medical Journal. 
Reissman, E., New York, American Journal of Surgery. 
Reynolds, D. S., Louisville, Ky,, Medical Progress. 
Richards, G. L., Fall River, Mass., Annals of Otology, Laryngology and 

Rhinology. 
Ripperger, A„ New York, Medizinische Monatsschrift, 
Robinovitch, L. G,, New York City, The Journal of Mental Pathology. 
Robinson, W. J,, New York, Critic and Guide, 
Rockwell, Margaret H,, Toledo, O., Woman's Medical Journal. 
Root, E. H,, Chicago, Ills., Woman's Medical Journal, 
Ross, J., Halifax, N, S., Maritime Medical News. 
Russell, A. L., Medical World, Midway, Pa. 
Sajous, C, E, de M., Philadelphia, Pa,, Monthly Cyclopedia of Practical 

Medicine. 
Samuel, F. W,, Louisville, Ky.. American Practitioner and News. 
Sayre, R, H., New York City, Sajous Cyclopedia of Medicine, 
Schenck, B. R., Detroit, Midi., Journal of Michigan State Medical Society. 
Scudder, Jno, K., Cincinnati, O,, Eclectic Medical Journal, 
Searle, F. W., Portland, Me. 

Shedd, P, W., New York City, North American Journal of Homeopathy, 
Simmons, H. M., Baltimore, Md., Maryland Medical Journal. 
Simmons, B. L., Greenville, Tenn,, Eclecticism. 

Skinner, C. E,, New Haven, Conn,, Arvhives of Physiological Therapy, 
Smith, C, E., Seattle, Wash., Northwest Medicine, 
Smith, E. F., New York, American Journal of Surgery. 
Smith, M. M., Austin, Tex,, Texas Medical News, 
Snow, W. B., New York, Journal of Advanced Therapeutics. 
Snow, M. L. H, A,, New York, Journal of Advanced Therapeutics. 
South, L. H,, Bowling Green, Ky,, Kentucky Medical Journal. 
Stedman, T. L., New York, Medical Record. 

Stephenson, C. C,, Little Rock, Ark., Journal of Arkansas Medical Society. 
Stern, A, E., Indianapolis, Ind., Medical and Surgical Monitor. 
Stern, Heinrich, New York, Archives of Diagnosis. 



)vGoo'^lc 



134 LIST OF MEMBERS. 

Stevens, C. L., Athens, Pa., Pennsylvania Medical Journal. 

Stevens, T. A., Caney, Kan., CHclahoma, Medical News Journal 

Strcrfiach, George, Cincinnati, O., Lancet Clinic. 

Taylor, C. F., Philadelphia, Pa., Medical World. 

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